Obesity is an aggravating factor in relapsing-remitting MS. A new study delves into the underlying mechanisms of the relationship between lipid metabolism and multiple sclerosis. 

The research by the Unit of Neurology and Neurorehabilitation of the I.R.C.C.S. Neuromed in Pozzilli, Italy, involving 140 patients, showed that at the time of diagnosis obese patients have a greater risk of presenting a higher Expanded Disability Status Scale score, the tool commonly used to assess the severity of multiple sclerosis. Neuromed researchers have also investigated, from a biochemical point of view, the relationship between MS and excessive body weight, analyzing the levels of inflammation in the central nervous system and the lipids concentrations in the blood (cholesterol and triglycerides).

Analysis of cerebrospinal fluid (collected with lumbar puncture) showed in obese patients higher levels of interleukin-6 (IL-6) and leptin, two molecules well known as promoters of the inflammatory process. In contrast, interleukin-13 (IL-13), with anti-inflammatory action, was reduced. Regarding lipid profile, higher levels of triglycerides and a higher ratio of total to HDL cholesterol have been correlated to higher IL-6 levels.

The researchers said the results suggest that excessive body weight, or altered lipid profile, are associated to increased central inflammation causing a worse clinical expression of the disease. They also said that specific strategies, such as diet or increased physical activity, may pave the way to the possibility of improving the condition of patients with MS, contrasting the increase of disability over time.

The findings were published in the Multiple Sclerosis Journal.