Excess weight, central adiposity and pro-inflammatory diet consumption in patients with neuromyelitis optica spectrum disorder

Paz, Éllen Sousa; Maciel, Paula Maria Cals Theophilo; D'Almeida, José Artur Costa; Silva, Bruna Yhang da Costa; Sampaio, Helena Alves de Carvalho; Pinheiro, Alexandre Danton Viana; Carioca, Antônio Augusto Ferreira; Melo, Maria Luísa Pereira de

doi:10.1016/j.msard.2021.103110

Cited by 11 publications

(12 citation statements)

References 32 publications

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“…The association between dietary in ammatory index (DII) and the increased risk of NMOSD was revealed in a previous study 27 . According to Woudenbergh.et al 28 , a high fat, high carbohydrate dietary with low quantity of vegetables and fruit, is associated with a higher DII, which may result in an increased risk of NMOSD.…”

Section: Discussionmentioning

confidence: 85%

Prognosis of Neuromyelitis Optica Spectrum Disorders: Differences Between Han Chinese and Tibetans, a retrospective cohort study

Luo

Wang

Shi

et al. 2022

Preprint

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Purpose To investigate the demographic characteristics and prognosis of Tibetan and Han Chinese patients with optic neuromyelitis Optica spectrum disorders (NMOSD). Methods From January 2015 to January 2022, 860 NMOSD patients were in our database. The demographic and clinical characteristics were described and retrospectively analyzed. In the subsequent analysis, we used 2 methods to eliminate confounding: a 1:3 propensity score matching (PSM) was performed and univariable cox regression was used to analyze the effect of ethnicity to prognosis; besides, univariable and multivariable cox regression was performed in the original cohort to explore the relationship between ethnicity and disability. The risk of relapse, severe attack, visual disability, motor disability and total disability in different races were analyzed. Results This study included 406 NMOSD patients (25 Tibetans and 381 Han), with a mean onset age of 40 ± 40 years, an 89% female population, and a median disease duration of 50 months. The most affected areas were the optic nerve (48%) and spinal cord (76%), no Tibetans developed area postrema syndromes (APS). 322 (79%) patients suffered at least 1 relapse, 156 (38%) suffered severe attack, 60 (15%) and 47 (12%) patients developed permanent visual and motor disability respectively. The total rate of disability was 23% (98 patients). Results from both methods showed a higher risk of severe attack, visual disability, and total disability in Tibetan, but the risk of relapse and motor disability did not differ between races. Conclusions our study demonstrated that compared with Han Chinese, Tibetans show a higher risk of disability.

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Section: Discussionmentioning

confidence: 85%

Prognosis of Neuromyelitis Optica Spectrum Disorders: Differences Between Han Chinese and Tibetans, a retrospective cohort study

Luo

Wang

Shi

et al. 2022

Preprint

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“… 9 Our results do not support a relationship between history of infectious mononucleosis, obesity or physical activity with NMOSD, despite some conflicting reports in the past literature. 7 , 16 – 18 This study illustrates the importance of controlled studies to investigate environmental risk factors for NMOSD, and consideration of potential confounders such as sex, age, ethnicity and place of birth in study design and analysis.…”

Section: Discussionmentioning

confidence: 92%

A national case–control study investigating demographic and environmental factors associated with NMOSD

et al. 2023

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Background: Risk factors for aquaporin-4 (AQP4+) antibody neuromyelitis optica spectrum disorder (NMOSD) are not well-established. Objective: To investigate demographic and environmental factors associated with NMOSD using a validated questionnaire and case–control design. Methods: We enrolled patients with AQP4 + NMOSD through six Canadian Multiple Sclerosis Clinics. Participants completed the validated Environmental Risk Factors in Multiple Sclerosis Study (EnvIMS) questionnaire. Their responses were compared to those of 956 unaffected controls from the Canadian arm of EnvIMS. We calculated odds ratios (ORs) for the association between each variable and NMOSD using logistic regression and Firth’s procedure for rare events. Results: In 122 participants (87.7% female) with NMOSD, odds of NMOSD in East Asian and Black participants were ⩾8 times that observed in White participants. Birthplace outside Canada was associated with an increased risk of NMOSD (OR = 5.5, 95% confidence interval (CI) = 3.6–8.3) as were concomitant autoimmune diseases (OR = 2.7, 95% CI = 1.4–5.0). No association was observed with reproductive history or age at menarche. Conclusion: In this case–control study, risk of NMOSD in East Asian and Black versus White individuals was greater than that observed in many previous studies. Despite the preponderance of affected women, we did not observe any association with hormonal factors such as reproductive history or age at menarche.

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“…25 However, studies on the effects of obesity on NMOSD have shown different results. 13,14,25 Baek et al 13 reported that a low BMI was a risk factor for poor outcomes in female NMOSD patients. Paz et al 14 did not find an effect of excess weight in patients with NMOSD in their case-control study, but a relatively small sample size (26 pairs) may have limited the power of the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study reported an association between lower BMI and poor outcomes in female AQP4-IgG seropositive NMOSD patients, 13 while another study suggested no correlation between NMOSD severity and BMI. 14 Limited by the relatively small sample size, the effect of BMI on the clinical features, disease course, and prognosis of NMOSD has not been adequately studied. Therefore, a large-scale observational study is required to determine the role of BMI in patients with NMOSD.…”

Section: Introductionmentioning

confidence: 99%

Initial BMI effects on clinical presentation and prognosis in neuromyelitis optica spectrum disorder

Luo

Wang

Kong

et al. 2023

Ann Clin Transl Neurol

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ObjectiveTo investigate the correlation among body mass index at onset, clinical features, and prognosis in patients with neuromyelitis optica spectrum disorder.MethodThis retrospective cohort studied patients with neuromyelitis optica spectrum disorder from January 2015 to January 2022, grouping them by body mass index at onset. Demographics and clinical records were reviewed. Anderson–Gill, Kaplan–Meier, and Cox models evaluated the body mass index's effect on relapse risk and long‐term outcomes.ResultsOf 246 patients with 799 neuromyelitis optica spectrum disorder attacks study, 36 patients had low, 133 had normal, 77 had high body mass index, with a mean onset age of 40 ± 13 years, and the population was 88% female. The medium follow‐up time was 49 months; AQP4‐IgG was found in 193 (78%) patients. Onset and relapse of area postrema syndrome were less frequent in patients with a normal body mass index. The annual relapse rate after immunosuppressive therapy was significantly lower in patients with a low body mass index. In the multivariable analysis, statistical correlation still existed between body mass index at onset and risk of relapse (HR = 1.03, 95% CI: 1.03–1.03, P < 0.001), risk of severe attack (HR = 0.92, 95% CI: 0.86–0.98, P = 0.013), risk of visual disability (HR = 0.9, 95% CI: 0.81–1, P = 0.047), and overall risk of disability (HR = 0.89, 95% CI: 0.82–0.98, P = 0.015) after adjusting various variables.InterpretationLower body mass index at onset was associated with less frequent relapse but poor prognosis.

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Excess weight, central adiposity and pro-inflammatory diet consumption in patients with neuromyelitis optica spectrum disorder

Cited by 11 publications

References 32 publications

Prognosis of Neuromyelitis Optica Spectrum Disorders: Differences Between Han Chinese and Tibetans, a retrospective cohort study

Prognosis of Neuromyelitis Optica Spectrum Disorders: Differences Between Han Chinese and Tibetans, a retrospective cohort study

A national case–control study investigating demographic and environmental factors associated with NMOSD

Initial BMI effects on clinical presentation and prognosis in neuromyelitis optica spectrum disorder

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