Disability in patients with multiple sclerosis: Influence of insulin resistance, adiposity, and oxidative stress

Abstract Objective The aims of the present study were to report the prevalence of insulin resistance (IR) in patients with multiple sclerosis (MS); to verify differences in metabolic and inflammatory biomarkers, and oxidative stress in patients with MS with or without IR; and to assess if IR and adi...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2014-03, Vol.30 (3), p.268-273
Main Authors: Oliveira, Sayonara Rangel, M.Sc, Colado Simão, Andréa Name, Ph.D, Kallaur, Ana Paula, M.Sc, Delicato de Almeida, Elaine Regina, M.Sc, Morimoto, Helena Kaminami, M.Sc, Lopes, Josiane, M.Sc, Dichi, Isaias, Ph.D, Kaimen-Maciel, Damácio Ramon, Ph.D, Vissoci Reiche, Edna Maria, Ph.D
Format: Article
Language:English
Subjects:
Adiposity
Adult
Anthropometry
Biological and medical sciences
Biomarkers
Blood Pressure
Body Composition
Body Mass Index
Cholesterol
Colleges & universities
Cross-Sectional Studies
Cytokines
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - etiology
EDSS
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
Humans
Insulin Resistance
Interleukin-17 - blood
Interleukin-6 - blood
Male
Medical sciences
Middle Aged
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - pathology
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Obesity - epidemiology
Oxidative Stress
Prevalence
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Waist Circumference
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Summary:Abstract Objective The aims of the present study were to report the prevalence of insulin resistance (IR) in patients with multiple sclerosis (MS); to verify differences in metabolic and inflammatory biomarkers, and oxidative stress in patients with MS with or without IR; and to assess if IR and adiposity are associated with disability in these patients. Methods The study enrolled 110 patients with MS and 175 healthy individuals. Patients with MS were divided in those with IR (n = 44) and those without (n = 66). Metabolic and inflammatory markers, oxidative stress, and disability were evaluated by the Extended Disability Status Scale (EDSS). Results IR prevalence was verified in 40% of the patients with MS and in 21.1% of the control group (odds ratio, 2.48; 95% confidence interval, 1.469–4.210; P = 0.0006). Patients with the disease and IR showed higher EDSS ( P = 0.031), interleukin (IL)-6 ( P = 0.028), IL-17 ( P = 0.006), oxidative stress evaluated by tert-butyl hydroperoxide-initiated chemiluminescence ( P = 0.029), and advanced oxidation protein products ( P = 0.025) than those patients without IR. The multivariate analysis showed that disability was associated with IR evaluated by homeostasis model assessment of insulin resistance ( P = 0.030) and adiposity evaluated by waist circumference ( P = 0.0179) and body mass index ( P = 0.0033). Conclusion This is the first study to demonstrate an increase IR prevalence and the association between IR and adiposity with disability assessed by EDSS in patients with MS. IR seems to be associated with chronic inflammatory process and oxidative stress in patients with MS. More studies are warranted to elucidate the mechanisms by which IR and adiposity could contribute to the progression and disability in patients with MS.
ISSN:0899-9007
1873-1244
DOI:10.1016/j.nut.2013.08.001