Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
J Clin Lipidol. 2019 Jul-Aug;13(4):654-663.e1. doi: 10.1016/j.jacl.2019.06.003. Epub 2019 Jun 18.
Fatigue is a frequent symptom in multiple sclerosis (MS). The role of cholesterol and lipids in MS fatigue has not been investigated.
To investigate the associations of cholesterol biomarkers and serum neurofilament light chain (sNfL) with fatigue in relapsing-remitting MS.
This cross-sectional study included 75 relapsing-remitting MS patients (69% female, mean age ± SD: 49.6 ± 11 years and median Expanded Disability Status Scale score: 2.0). Fatigue, disability, and depression were assessed with Fatigue Severity Scale (FSS), Expanded Disability Status Scale, and the Beck Depression Index-Fast Screen, respectively. sNfL was measured using single-molecule array technology. Plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and an apolipoprotein panel data were obtained. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), chemokine (C-C motif) ligand 5 (CCL5 or RANTES), and CCL18 levels were measured to assess inflammation.
The mean FSS was 4.27 ± 1.73, and 57% had severe fatigue status (SFS, FSS ≥ 4.0). In regression analyses adjusted for age, sex, disability, and depression, lower FSS and SFS were associated with greater HDL-C (P = .006 for FSS, and P = .016 for SFS) and lower TC to HDL-C ratio (P = .011 for FSS, and P = .009 for SFS). Apolipoprotein A-II was also associated with FSS (P = .022). sNfL, CCL5, CCL18, sICAM-1, and sVCAM-1 levels were not associated with fatigue after adjusting for disability and depression.
TC to HDL-C ratio is associated with MS fatigue. Our results implicate a potential role for the HDL-C pathway in MS fatigue and could provide possible targets for the treatment of MS fatigue.
疲劳是多发性硬化症（MS）的常见症状。胆固醇和脂质在 MS 疲劳中的作用尚未得到研究。
研究胆固醇生物标志物和血清神经丝轻链（sNfL）与复发缓解型 MS 疲劳的关系。
本横断面研究纳入了 75 名复发缓解型 MS 患者（69%为女性，平均年龄±标准差：49.6±11 岁，扩展残疾状况量表中位数：2.0）。疲劳、残疾和抑郁分别用疲劳严重程度量表（FSS）、扩展残疾状况量表和贝克抑郁指数快速筛查量表进行评估。使用单分子阵列技术测量 sNfL。获得血浆总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和载脂蛋白谱数据。测量可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）、趋化因子（C-C 基元）配体 5（CCL5 或 RANTES）和 CCL18 水平以评估炎症。
平均 FSS 为 4.27±1.73，57%的患者存在严重疲劳状态（FSS，FSS≥4.0）。在调整年龄、性别、残疾和抑郁的回归分析中，较低的 FSS 和 SFS 与较高的 HDL-C（FSS 为 P=0.006，SFS 为 P=0.016）和较低的 TC/HDL-C 比值（FSS 为 P=0.011，SFS 为 P=0.009）相关。载脂蛋白 A-II 也与 FSS 相关（P=0.022）。调整残疾和抑郁后，sNfL、CCL5、CCL18、sICAM-1 和 sVCAM-1 水平与疲劳无关。
TC/HDL-C 比值与 MS 疲劳有关。我们的结果表明，HDL-C 通路可能在 MS 疲劳中起作用，并为 MS 疲劳的治疗提供了可能的靶点。
