Mogiłko Natalia, Małgorzewicz Sylwia
Department of Neurology and Clinical Neuroimmunology, Specialist Hospital in Grudziądz, 86-300 Grudziądz, Poland.
Department of Clinical Nutrition, Medical University of Gdańsk, 80-211 Gdańsk, Poland.
Biomolecules. 2025 May 12;15(5):703. doi: 10.3390/biom15050703.
Recent studies indicate that in progressive multiple sclerosis (MS)-an inflammatory and degenerative disease of the central nervous system-the biological pathways associated with these effects remain poorly understood. Changes in body weight, whether presenting as overweight or underweight, as well as alterations in adipose and muscle tissue, together with chronic inflammation, may contribute to the disease and influence its course.
This case-control study aimed to measure inflammatory markers and myokine levels (myostatin and irisin), brain-derived neurotrophic factor (BDNF), and IL-6 in the serum of patients with multiple sclerosis and healthy control and assess whether the myokines and cytokines are associated with nutritional status.
The study included 92 MS patients and 75 healthy volunteers. Nutritional status was assessed using the NRS (Nutritional Risk Screening) 2002 and GLIM (Global Leadership Initiative on Malnutrition) criteria. The risks of malnutrition or malnutrition were diagnosed based on ESPEN recommendations. Body composition analysis was performed using the BIA method with the InBody 120 analyzer. Routine laboratory parameters (albumin, lipidogram) were measured. Myostatin, irisin, BDNF, IL-6, and hsCRP were measured using ELISA methods. Statistical analysis was conducted using Statistica 13.0 software. Comparisons between the two groups were conducted using Student's -test for normally distributed variables and the Mann-Whitney U test for non-normally distributed variables; the differences between groups were calculated using either ANOVA or the Kruskal-Wallis test. Post hoc analysis by the Bonferroni method was applied.
In the MS group, high risks of malnutrition (69.0%) and malnutrition (14.0%) were observed. A statistically significant correlation was found between malnutrition (GLIM) and s-albumin (R = 0.2; < 0.05) and hsCRP (R = 0.23; < 0.05). The MS patient group displayed significantly lower levels of irisin, higher levels of hsCRP, and lower s-albumin compared to healthy volunteers. Malnourished patients with MS exhibited significantly lower irisin levels, as well as higher hsCRP in comparison to MS patients who were at risk or well nourished. The levels of myostatin, BDNF, and IL6 did not differ depending on nutritional status. Irisin correlated with hsCRP (R Spearman = -0.5; = 0.01).
Our findings highlight the interplay between chronic inflammation, nutritional status, and myokines level in multiple sclerosis.
最近的研究表明，在进展性多发性硬化症（MS）——一种中枢神经系统的炎症性和退行性疾病——中，与这些影响相关的生物学途径仍知之甚少。体重变化，无论是超重还是体重不足，以及脂肪和肌肉组织的改变，再加上慢性炎症，可能会导致该疾病并影响其病程。
本病例对照研究旨在测量多发性硬化症患者和健康对照者血清中的炎症标志物和肌动蛋白水平（肌肉生长抑制素和鸢尾素）、脑源性神经营养因子（BDNF）和白细胞介素-6，并评估肌动蛋白和细胞因子是否与营养状况相关。
该研究纳入了92例MS患者和75名健康志愿者。使用2002年营养风险筛查（NRS）和全球营养不良领导倡议（GLIM）标准评估营养状况。根据欧洲临床营养和代谢学会（ESPEN）的建议诊断营养不良或营养风险。使用InBody 120分析仪通过生物电阻抗分析（BIA）方法进行身体成分分析。测量常规实验室参数（白蛋白、血脂谱）。使用酶联免疫吸附测定（ELISA）方法测量肌肉生长抑制素、鸢尾素、BDNF、白细胞介素-6和高敏C反应蛋白（hsCRP）。使用Statistica 13.0软件进行统计分析。两组之间的比较对于正态分布变量使用学生t检验，对于非正态分布变量使用曼-惠特尼U检验；组间差异使用方差分析（ANOVA）或克鲁斯卡尔-沃利斯检验计算。采用Bonferroni方法进行事后分析。
在MS组中，观察到高营养不良风险（69.0%）和营养不良（14.0%）。发现营养不良（GLIM）与血清白蛋白（R = 0.2；P < 0.05）和hsCRP（R = 0.23；P < 0.05）之间存在统计学显著相关性。与健康志愿者相比，MS患者组的鸢尾素水平显著降低，hsCRP水平升高，血清白蛋白水平降低。与有风险或营养良好的MS患者相比，营养不良的MS患者的鸢尾素水平显著降低，hsCRP水平更高。肌肉生长抑制素、BDNF和白细胞介素-6的水平不因营养状况而异。鸢尾素与hsCRP相关（斯皮尔曼R = -0.5；P = 0.01）。
我们的研究结果突出了多发性硬化症中慢性炎症、营养状况和肌动蛋白水平之间的相互作用。
