Impact of body mass index on fatigue in multiple sclerosis, neuromyelitis optica spectrum disorder and myelin-oligodendrocyte glycoprotein associated disease

초록

Background: Obesity is a risk factor for multiple sclerosis (MS) and overweight patients with MS experience worse self-reported health status. Still, the association between fatigue and obesity in MS is not precisely known, as is the case in neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD). Objective: We tried to investigate the effect of body mass index (BMI) on fatigue and self-reported health statuses such as sleep, depression, pain, and quality of life in Korean patients with MS, NMOSD, and MOGAD. Methods: In a prospective cohort of CNS demyelinating disease, we collected BMIs of patients and surveys of the modified fatigue impact scale (MFIS), Pittsburgh Sleep Quality Index (PSQI), Short Form-36 (SF-36), Beck Depression Index-II (BDI-II), and Brief pain inventory (BPI). We also collected patient clinical information such as gender, age, number of attacks, and duration of disease. Patients who performed the surveys at least once were analyzed, and the BMI at the time of the survey and the BMI at the time of disease onset were compared with survey scales. Results: A total of 75 patients with MS (age, 30.9±11.2 y, F:M=58:17), 54 patients with NMOSD (age, 40.0±14.0 y, F:M=49: 5), and 35 patients with MOGAD (age, 40.3±17.0 y, F:M= 16:19) were analyzed. BMI at the time of survey and BMI at onset of disease was significantly higher in MOGAD (25.7±3.9, 25.4±5.8), compared to MS (23.8±4.1, 23.3±3.6) and NMOSD (23.1±4.6, 22.4±3.9) patients, whereas there were no significant differences between MFISs of three groups. A significant negative association between BMI and MFIS was observed in patients with MS (B=-0.960, p=0.005), while a positive association between BMI and MFIS was found in patients with MOGAD (B=1.781, p=0.015). In addition, there was a significant positive association between BMI and PSQI (B=0.353, p Conclusion: This study suggests that BMI is higher in patients with MOGAD, compared to MS and NMOSD and that higher BMI is associated with less fatigue in patients with MS, but more fatigue in patients with MOGAD. Further large-scale prospective studies are war Disclosures: JHM has lectured, consulted, and received Honoria from Bayer Schering Pharma, Merck Serono, Biogen Idec, Sanofi Genzyme, Teva-Handok, UCB, Samsung Bioepis, Mitsubishi Tanabe Pharma, Kolon Life Science, and Roche; received a grant from the National Research Foundation of Korea and SMC Research and Development Grant. HJ and YHJ have nothing to disclose.