Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 142013, USA.
Department of Neurology, Jacobs Multiple Sclerosis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.
J Neurol. 2019 Apr;266(4):866-875. doi: 10.1007/s00415-019-09208-0. Epub 2019 Feb 13.
Evidence regarding the role, if any, of dietary and lifestyle factors in the pathogenesis of multiple sclerosis (MS) is poorly understood.
To assess the effect of lifestyle-based risk factors linked to cardiovascular disease (CVD) on clinical and MRI-derived MS outcomes.
The study enrolled 175 MS or clinically isolated syndrome (CIS) patients and 42 age- and sex-matched healthy controls (HCs) who were longitudinally followed for 5.5 years. The 20-year CVD risk was calculated by Healthy Heart Score (HHS) prediction model which includes age, smoking, body mass index, dietary intake, exercise, and alcohol consumption. Baseline and follow-up MRI scans were obtained and cross-sectional and longitudinal changes of T2-lesion volume (LV), whole brain volume (WBV), white matter volume (WMV), gray matter volume (GMV), and lateral ventricular volume (LVV) were calculated.
After correcting for disease duration, the baseline HHS values of the MS group were associated with baseline GMV (r = - 0.20, p = 0.01), and longitudinal LVV change (r = 0.19, p = 0.01). The association with LVV remained significant after adjusting for baseline LVV volumes (r = 0.2, p = 0.008) in MS patients. The diet component of the HHS was associated with the 5-year T2-LV accrual (r = - 0.191, p = 0.04) in MS. In the HC group, the HHS was associated with LVV (r = 0.58, p < 0.001), GMV (r = - 0.57, p < 0.001), WBV (r = - 0.55, p = 0.001), T2-LV (r = 0.41, p = 0.027), and WMV (r = - 0.38, p = 0.042). Additionally, the HC HHS was associated with the 5-year change in LVV (r = 0.54, p = 0.001) and in WBV (r = - 0.45, p = 0.011).
Lifestyle risk factors contribute to accelerated central brain atrophy in MS patients, whereas unhealthier diet is associated with MS lesion accrual. Despite the lower overall effect when compared to HCs, lifestyle-based modifications may still provide a beneficial effect on reducing brain atrophy in MS patients.
有关饮食和生活方式因素在多发性硬化症（MS）发病机制中的作用的证据了解甚少。
评估与心血管疾病（CVD）相关的基于生活方式的风险因素对 MS 的临床和 MRI 结果的影响。
这项研究纳入了 175 名 MS 或临床孤立综合征（CIS）患者和 42 名年龄和性别匹配的健康对照者（HCs），对他们进行了 5.5 年的纵向随访。使用健康心脏评分（HHS）预测模型计算 20 年 CVD 风险，该模型包括年龄、吸烟、体重指数、饮食摄入、运动和饮酒。获取基线和随访 MRI 扫描，并计算 T2 病变体积（LV）、全脑体积（WBV）、白质体积（WMV）、灰质体积（GMV）和侧脑室体积（LVV）的横断面和纵向变化。
在校正疾病持续时间后，MS 组的基线 HHS 值与基线 GMV 相关（r = -0.20，p = 0.01），与纵向 LVV 变化相关（r = 0.19，p = 0.01）。在调整 MS 患者的基线 LVV 体积后，LVV 的相关性仍然显著（r = 0.2，p = 0.008）。HHS 的饮食成分与 MS 患者的 5 年 T2-LV 增加相关（r = -0.191，p = 0.04）。在 HC 组中，HHS 与 LVV（r = 0.58，p < 0.001）、GMV（r = -0.57，p < 0.001）、WBV（r = -0.55，p = 0.001）、T2-LV（r = 0.41，p = 0.027）和 WMV（r = -0.38，p = 0.042）相关。此外，HC 的 HHS 与 LVV（r = 0.54，p = 0.001）和 WBV（r = -0.45，p = 0.011）的 5 年变化相关。
生活方式危险因素导致 MS 患者的中枢脑萎缩加速，而不健康的饮食与 MS 病变的积累有关。尽管与 HCs 相比，整体影响较低，但基于生活方式的改变可能仍会对减少 MS 患者的脑萎缩产生有益的影响。
