Association between BMI and disability in Korean patients with multiple sclerosis and neuromyelitis optica spectrum disorder

초록

Introduction: Obesity is known to be associated with the risk or disability in patients with multiple sclerosis (MS), whereas low body mass index (BMI) was reported to be associated with mortality in neuromyelitis optica spectrum disorder (NMOSD). Objectives: Herein, we tried to investigate the effect of BMI on disability in patients with MS and NMOSD. Methods: Using a prospective cohort of CNS demyelinating disease, we analyzed BMIs in Korean patients with MS and NMOSD. Demographic data and clinical characteristics including the history of comorbidities such as diabetes, hypertension, heart disease, chronic kidney disease, cancer, dyslipidemia, and smoking, were also collected. Results: A total of 89 patients with MS (median age, 29 years; female = 62) and 72 patients with NMOSD (median age, 39 years; female = 61) were enrolled. Duration from onset of disease to initial BMI measurement of the patient was 1 year (InterQuartile Range (IQR) 1~3) in both groups. Age at onset was significantly higher in patients with NMOSD than those with MS, although the frequencies of other comorbidities were similar between the two groups, except cancers (NMOSD, N=9; MS, N=1; p<0.01). BMI was not significantly different between patients with MS (median, 22.96) and those with NMOSD (median, 21.76), although EDSS score at BMI of initial measurement was significantly higher in the NMOSD group than the MS group (median, 3 vs 2). BMI at initial measurement of patients with NMOSD showed a significant negative association with EDSS score at the time of BMI (ß = -0.3652, S.E.=0.1628, p = 0.0282), whereas there was no significant association between BMI and EDSS score in patients with MS. Conclusion: The present study showed that low BMI was associated with disability in NMOSD, but there was no effect of BMI on disability in MS, which may suggest different immunometabolic interplay in the two disorders. In addition, the association of BMI with cancer in NMOSD remains to be further investigated.