title: Serum lipid profiles are associated with disability and MRI outcomes in multiple sclerosis.
abstract: BACKGROUND
  The breakdown of the blood-brain-barrier vascular endothelium is critical for entry of immune cells into the MS brain. Vascular co-morbidities are associated with increased risk of progression. Dyslipidemia, elevated LDL and reduced HDL may increase progression by activating inflammatory processes at the vascular endothelium.
  
  
  OBJECTIVE
  To assess the associations of serum lipid profile variables (triglycerides, high and low density lipoproteins (HDL, LDL) and total cholesterol) with disability and MRI measures in multiple sclerosis (MS).
  
  
  METHODS
  This study included 492 MS patients (age: 47.1 ± 10.8 years; disease duration: 12.8 ± 10.1 years) with baseline and follow-up Expanded Disability Status Score (EDSS) assessments after a mean period of 2.2 ± 1.0 years. The associations of baseline lipid profile variables with disability changes were assessed. Quantitative MRI findings at baseline were available for 210 patients.
  
  
  RESULTS
  EDSS worsening was associated with higher baseline LDL (p = 0.006) and total cholesterol (p = 0.001, 0.008) levels, with trends for higher triglyceride (p = 0.025); HDL was not associated. A similar pattern was found for MSSS worsening. Higher HDL levels (p < 0.001) were associated with lower contrast-enhancing lesion volume. Higher total cholesterol was associated with a trend for lower brain parenchymal fraction (p = 0.033).
  
  
  CONCLUSIONS
  Serum lipid profile has modest effects on disease progression in MS. Worsening disability is associated with higher levels of LDL, total cholesterol and triglycerides. Higher HDL is associated with lower levels of acute inflammatory activity.
authors.affiliation: Department of Neurology, State University of New York, Buffalo, NY, USA. BGuttman@theJNI.Org
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
authors.forename: Naeem
authors.initials: N
authors.lastname: Mahfooz
authors.forename: Ellen
authors.initials: E
authors.lastname: Carl
authors.forename: Allison
authors.initials: A
authors.lastname: Drake
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Schneider
authors.forename: Barbara
authors.initials: B
authors.lastname: Teter
authors.forename: Sara
authors.initials: S
authors.lastname: Hussein
authors.forename: Bijal
authors.initials: B
authors.lastname: Mehta
authors.forename: Marc
authors.initials: M
authors.lastname: Weiskopf
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Durfee
authors.forename: Niels
authors.initials: N
authors.lastname: Bergsland
authors.forename: Murali
authors.initials: M
authors.lastname: Ramanathan
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier / Q000473:pathology; D002784:Cholesterol / Q000097:blood; D004185:Disability Evaluation; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology*; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol