Obesity worsens central inflammation and disability in multiple sclerosis

Mario Stampanoni Bassi, Ennio Iezzi, Fabio Buttari, Luana Gilio, Ilaria Simonelli, Fortunata Carbone, Teresa Micillo, Veronica De Rosa, Francesco Sica, Roberto Furlan, Annamaria Finardi, Roberta Fantozzi, Marianna Storto, Paolo Bellantonio, Pamela Pirollo, Sonia Di Lemme, Alessandra Musella, Georgia Mandolesi, Diego Centonze, Giuseppe Matarese

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Previous studies evidenced a link between metabolic dysregulation, inflammation, and neurodegeneration in multiple sclerosis (MS).

OBJECTIVES: To explore whether increased adipocyte mass expressed as body mass index (BMI) and increased serum lipids influence cerebrospinal fluid (CSF) inflammation and disease severity.

METHODS: In this cross-sectional study, 140 consecutive relapsing-remitting (RR)-MS patients underwent clinical assessment, BMI evaluation, magnetic resonance imaging scan, and blood and CSF collection before any specific drug treatment. The CSF levels of the following cytokines, adipocytokines, and inflammatory factors were measured: interleukin (IL)-6, IL-13, granulocyte macrophage colony-stimulating factor, leptin, ghrelin, osteoprotegerin, osteopontin, plasminogen activator inhibitor-1, resistin, and Annexin A1. Serum levels of triglycerides, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were assessed.

RESULTS: A positive correlation emerged between BMI and Expanded Disability Status Scale score. Obese RR-MS patients showed higher clinical disability, increased CSF levels of the proinflammatory molecules IL-6 and leptin, and reduced concentrations of the anti-inflammatory cytokine IL-13. Moreover, both the serum levels of triglycerides and TC/HDL-C ratio showed a positive correlation with IL-6 CSF concentrations.

CONCLUSION: Obesity and altered lipid profile are associated with exacerbated central inflammation and higher clinical disability in RR-MS at the time of diagnosis. Increased adipocytokines and lipids can mediate the negative impact of high adiposity on RR-MS course.

Original languageEnglish
Pages (from-to)1352458519853473
JournalMultiple Sclerosis
Publication statusE-pub ahead of print - Jun 4 2019


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