Open Access

Isabel Lutfullin, Maria Eveslage, Stefan Bittner, Gisela Antony, Martina Flaskamp, Felix Luessi, Anke Salmen, Barbara Gisevius, Luisa Klotz, Catharina Korsukewitz, Achim Berthele, Sergiu Groppa, Florian Then Bergh, Brigitte Wildemann, Antonios Bayas, Hayrettin Tumani, Sven G. Meuth, Corinna Trebst, Uwe K. Zettl, Friedemann Paul, Christoph Heesen, Tania Kuempfel, Ralf Gold, Bernhard Hemmer, Frauke Zipp, Heinz Wiendl, Jan D. Lünemann

• BackgroundObesity reportedly increases the risk for developing multiple sclerosis (MS), but little is known about its association with disability accumulation.MethodsThis nationwide longitudinal cohort study included 1066 individuals with newly diagnosed MS from the German National MS cohort. Expanded Disability Status Scale (EDSS) scores, relapse rates, MRI findings and choice of immunotherapy were compared at baseline and at years 2, 4 and 6 between obese (body mass index, BMI ≥30 kg/m2) and non-obese (BMI <30 kg/m2) patients and correlated with individual BMI values.ResultsPresence of obesity at disease onset was associated with higher disability at baseline and at 2, 4 and 6 years of follow-up (p<0.001). Median time to reach EDSS 3 was 0.99 years for patients with BMI ≥30 kg/m2 and 1.46 years for non-obese patients. Risk to reach EDSS 3 over 6 years was significantly increased in patients with BMI ≥30 kg/m2 compared with patients with BMI <30 kg/m2 after adjustment for sex, age,BackgroundObesity reportedly increases the risk for developing multiple sclerosis (MS), but little is known about its association with disability accumulation.MethodsThis nationwide longitudinal cohort study included 1066 individuals with newly diagnosed MS from the German National MS cohort. Expanded Disability Status Scale (EDSS) scores, relapse rates, MRI findings and choice of immunotherapy were compared at baseline and at years 2, 4 and 6 between obese (body mass index, BMI ≥30 kg/m2) and non-obese (BMI <30 kg/m2) patients and correlated with individual BMI values.ResultsPresence of obesity at disease onset was associated with higher disability at baseline and at 2, 4 and 6 years of follow-up (p<0.001). Median time to reach EDSS 3 was 0.99 years for patients with BMI ≥30 kg/m2 and 1.46 years for non-obese patients. Risk to reach EDSS 3 over 6 years was significantly increased in patients with BMI ≥30 kg/m2 compared with patients with BMI <30 kg/m2 after adjustment for sex, age, smoking (HR 1.87; 95% CI 1.3 to 2.6; log-rank test p<0.001) and independent of disease-modifying therapies. Obesity was not significantly associated with higher relapse rates, increased number of contrast-enhancing MRI lesions or higher MRI T2 lesion burden over 6 years of follow-up.ConclusionsObesity in newly diagnosed patients with MS is associated with higher disease severity and poorer outcome. Obesity management could improve clinical outcome of MS.…