Elevated cardiovascular risk factors in multiple sclerosis

Abstract

Background: Multiple sclerosis (MS) is associated with elevated cardiovascular mortality. To prevent this a better understanding of their CVD risk factors and interrelations is necessary.

Methods: MS patients (n = 52) and healthy controls (HC, n = 24) were matched for age, height, weight, body mass index and physical activity. Body composition, resting blood pressure (BP), resting heart rate (HR), glucose tolerance, HbA1c, blood lipids (HDL, LDL, total cholesterol, triglyceride concentrations) and c-reactive protein concentrations were analyzed. Regression analyses identified independent CVD risk factors and their interrelations in MS.

Results: In MS and compared to HC, fat mass (25.1 ± 1.2kg vs. 17.9 ± 1kg), fat percentage (33.8 ± 1.2% vs. 28.4 ± 1.5%), systolic (130 ± 1.8mmHg vs. 120 ± 2.9mmHg) and diastolic (79 ± 1.1mmHg vs. 71 ± 1.9mmHg) BP, resting HR (72 ± 1.4bpm vs. 60 ± 2bpm), blood triglycerides (113.8 ± 8.6mg/dl vs. 98.2 ± 17.4mg/dl), fasting (13.5 ± 2.9mU/l vs. 7.2 ± 0.8mU/l) and 2h insulin (71.9 ± 12.5mU/l vs. 35.8 ± 8.1mU/l), 2h glucose (6.3 ± 0.5mmol/l vs. 4.8 ± 0.5mmol/l) and HOMA index (3.7 ± 1.1 vs. 1.7 ± 0.2) were significantly (p < 0.05) elevated. Total cholesterol, blood HDL and LDL concentrations did nog differ between groups (p < 0.05). Regression analyses indicated that MS is independently associated with elevated fat mass/percentage, systolic and diastolic BP and HR and in MS fat mass appears to be an independent contributor of the other measured CVD risk factors in MS.

Conclusion: Persons with MS have an increased risk for CVD and fat mass appears to be an important risk factor. Therefore, normalizing whole body fat should be an essential part of MS treatment.

Keywords: Body composition; Cardiovascular diseases; Fat mass; Mortality; Multiple sclerosis.