The Relationship Between Body Mass Index (BMI) and Multiple Sclerosis Progression (P2.212)

Objective: To evaluate the relationship between BMI and MS progression as measured by the Expanded Disability Status Scale (EDSS), MRI new lesions, relapse rate, and the Timed 25 Foot Walk (T25FW). Background: Multiple Sclerosis (MS) is a progressive neurological disease leading to loss of function and disability. MS and obesity are both considered inflammatory diseases, and might be linked through pathophysiological processes. The relationship between Body Mass Index (BMI) and MS progression is unknown. Methods: Subjects were identified through age, gender, race, and disease duration and followed retrospectively for 5 years. Logistic regression analysis was performed to determine the association between the baseline BMI and MS progression: disability, new MRI lesions, relapse rate, and T25FW (n=150). Results: The mean age was 45.5 years, 79 [percnt] were females and the mean BMI was 27. The odds of having increased EDSS by at least 1 point in obese patients with mild disability was 8 times greater than those with normal BMI (p=.017). The odds of having new brain MRI lesions was 6.2 times greater in overweight subjects (p<.0001) and 2.6 times greater in obese subjects (p=.048) than in subjects with normal BMI. The odds of having at least 1 relapse in 5 years was 3.8 times (p=.040) in obese subjects than non-obese. The odds of having 20[percnt] change on the 25-foot walk was 1.1 (p=.047) times for each increase of one unit of the baseline BMI. Blacks had 5 times greater odds to have higher disability (p=.015) than Whites, and current smokers had 5 times greater odds to have increased disability than never smokers (p=.03). Conclusions: BMI may have an important role in MS outcomes. Assessment and addressing a plan of care with dietary guidelines and weight control programs for patients with MS may aid in minimizing the progression of the disease. Disclosure: Dr. Ben-Zacharia has received personal compensation for activities with Biogen Idec, Teva, Genzyme, Questcor, and Novartis as a consultant.