Martinez Arturo S, Bastian Alyanne J, Shemirani Farnoosh, Titcomb Tyler J, Bisht Babita, Darling Warren G, Ramanathan Murali, Shittu Mujeeb, Gill Christine M, Snetselaar Linda G, Wahls Terry L
Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA.
Department of Epidemiology, University of Iowa, Iowa City, IA 52242, USA.
Nutrients. 2025 Mar 27;17(7):1163. doi: 10.3390/nu17071163.
: Cardiometabolic comorbidities are common in multiple sclerosis (MS), and lifestyle interventions are effective in managing these conditions in the general population, though evidence in the MS patient population is limited. : To evaluate the effect of a multimodal lifestyle intervention on serum apolipoproteins (Apo), creatine kinase (CK), glucose, and insulin in people with progressive MS (PwPMS). : This study included = 19 PwPMS who participated in a 12-month multimodal lifestyle intervention (including a modified Paleolithic diet, exercise, neuromuscular electrical stimulation, supplements, and stress reduction). Lipid profile (ApoA1, B, and E), CK, glucose, and insulin were obtained at baseline and after 12 months under fasting conditions. : At 12 months, there was a marginally significant decrease in ApoB (mean change: -7.17 mg/dL; 95% CI: -14.4, 0.12; = 0.06), while no significant changes were observed for ApoA1 (mean change: -1.28 mg/dL; 95% CI: 12.33, 9.76; = 0.80), ApoE (mean change: +0.12 mg/dL; 95% CI: -0.27, 0.52; = 0.51), CK (mean change: +13.19 U/L; 95% CI: -32.72, 59.11; = 0.55), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (mean change: -0.44; 95% CI: -1.11, 0.22; = 0.17), and HOMA-β (mean change: +45.62; 95% CI: -95.6, 186.9; = 0.50). A positive association was observed between changes in HOMA-IR and fatigue changes at 12 months (β = 0.81, = 0.02), suggesting that an increase in HOMA-IR was linked to increased fatigue, which was no longer significant following the exclusion of outliers (β = 0.71, = 0.16). : A multimodal lifestyle intervention did not negatively impact glycemic and lipid profiles. While improvements were observed in serum biomarkers, these changes were not statistically significant, highlighting the need for stronger evidence from larger, controlled studies to confirm the cardiometabolic health benefits in PwPMS.
心血管代谢合并症在多发性硬化症（MS）中很常见，生活方式干预对普通人群管理这些病症有效，尽管在MS患者群体中的证据有限。
为了评估多模式生活方式干预对进展性MS患者（PwPMS）血清载脂蛋白（Apo）、肌酸激酶（CK）、葡萄糖和胰岛素的影响。
本研究纳入了19名PwPMS患者，他们参与了为期12个月的多模式生活方式干预（包括改良的旧石器时代饮食、运动、神经肌肉电刺激、补充剂和减压）。在空腹条件下于基线和12个月后获取血脂谱（ApoA1、B和E）、CK、葡萄糖和胰岛素数据。
在12个月时，ApoB有轻微显著下降（平均变化：-7.17mg/dL；95%CI：-14.4，0.12；P=0.06），而ApoA1（平均变化：-1.28mg/dL；95%CI：-12.33，9.76；P=0.80）、ApoE（平均变化：+0.12mg/dL；95%CI：-0.27，0.52；P=0.51）、CK（平均变化：+13.19U/L；95%CI：-32.72，59.11；P=0.55）、胰岛素抵抗稳态模型评估（HOMA-IR）（平均变化：-0.44；95%CI：-1.11，0.22；P=0.
