An adverse lipid profile is associated with disability and progression in disability, in people with MS.
BACKGROUND
There is accumulating data suggesting an association between serum lipids, apolipoproteins and disability in multiple sclerosis (MS).


OBJECTIVE
To investigate the associations between serum lipids, apolipoproteins and disability in MS.


METHODS
A cohort of 178 participants with clinically-definite MS in southern Tasmania, Australia were prospectively followed from 2002 - 2005, and serum samples were obtained at study entry and at each biannual review, to measure lipid profile and apolipoprotein levels. Associations with disability and annual change in disability were evaluated using linear regression and multilevel mixed-effects linear regression.


RESULTS
In the unadjusted analyses, nearly all lipid-related variables were positively associated with Expanded Disability Status Scale (EDSS). After adjustment for confounders, total cholesterol (TC) (p = 0.037), apolipoprotein B (ApoB) (p = 0.003), and the apolipoprotein B to apolipoprotein A-I ratio (ApoB/ApoA-I ratio) (p = 0.018) were independently associated with a higher EDSS. Higher body mass index (BMI) was also independently associated with higher EDSS (p = 0.013). With the progression analysis, the total cholesterol to high density lipoprotein (HDL) ratio (TC/HDL ratio) (p = 0.029) was prospectively associated with subsequent change in EDSS.


CONCLUSIONS
In this prospective population-based cohort study, an adverse lipid profile was associated with high levels of MS disability and disease progression. Improving serum lipids may be beneficial for MS patients, to potentially improve clinical outcomes and vascular comorbidities.
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Prudence
P
Tettey
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Steve
S
Simpson
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Bruce
B
Taylor
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Leigh
L
Blizzard
Murdoch Children's Research Institute, University of Melbourne, Australia.
Anne-Louise
AL
Ponsonby
Murdoch Children's Research Institute, University of Melbourne, Australia.
Terence
T
Dwyer
Mater Hospital, University of Queensland, Australia.
Karam
K
Kostner
Menzies Research Institute Tasmania, University of Tasmania, 17 Liverpool Street, Hobart TAS 7000, Australia ingrid.vanderMei@utas.edu.au.
Ingrid
I
van der Mei
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood*; D055815:Young Adult
D008055:Lipids
Apolipoprotein; body mass index; cholesterol; disability; lipid profile; multiple sclerosis; progression