Serum Lipoprotein Profile Is Associated With Protective Effects of Oral Contraceptive Use on Multiple Sclerosis Severity: A Cross-Sectional Study

Abstract

Background: The mechanisms underlying the influence of sex hormones in multiple sclerosis (MS) are uncertain. Sex steroids interact with cholesterol metabolism and the serum lipid profile has been associated with the severity of the disease. We hypothesized that the putative associations between lipoprotein metabolism and MS could be modulated by sex steroids exposure. The aim of this study was to investigate whether oral contraceptives (OC) use changes the lipoprotein profile associated with disability in patients with multiple sclerosis.Methods: Clinical data was collected from 133 relapsing-remitting multiple sclerosis (RRMS) women with a mean of 6.5 years of disease duration and prior to the start of disease-modifying therapies. Patients who were using OC after disease onset (DO) (OC+, n = 57) were compared to those who never used OC or discontinued its intake before DO (OC–, n = 76). In both cohorts of subjects, the associations between the apolipoprotein E (ApoE) polymorphism, and plasma lipid levels, and the annualized relapse rate (RR), the Expanded Disability Status Score (EDSS), and the Multiple Sclerosis Severity Score (MSSS) were evaluated using a hierarchic multiple regression analysis after adjustment for confounders.Results: Low density lipoprotein (LDL) levels were associated with higher EDSS (p = 0.010) and MSSS (p = 0.024) in the whole studied cohort. In E3/E3 phenotype carriers (73.7%), EDSS and MSSS were lower in OC+ in comparison with OC– subgroup of patients (p < 0.01). LDL and total cholesterol were associated with EDSS (p = 0.005 and p = 0.043, respectively), and LDL and the triglyceride/high density lipoprotein ratio with MSSS (p = 0.011 and p = 0.048, respectively) in OC+ patients. In OC– subgroup of patients, ApoE levels were associated with EDSS (p = 0.012) and MSSS (p = 0.031). No significant interactions between the lipid variables or OC use and RR were observed.Conclusions: Serum lipid profile is associated with protective effects of OC use on disability of RRMS patients. Lipoprotein metabolism may be involved in the modulatory effects of sex steroids on the severity of the disease.

ε 2 , ε 3 , and ε 4 variants of ApoE ; rs2228570 (VDR) , rs4588 and rs7041 (VDBP) polymorphisms in patients with multiple sclerosis: A case–control study in Turkish population

“…Therefore, any distortion in these biomolecules is likely to give rise to severe problems which may end up with neuron loss. Current findings support the idea of such relation between lipid profile and disease progression 89,95‐99 . As we investigated similar characteristics, data showed considerable difference in terms of high total cholesterol, triglyceride, and LDL‐C levels as well as low HDL‐C level in cases.…”

Sex-Specific Effect of Serum Lipids and Body Mass Index on Psychotic Symptoms, a Cross-Sectional Study of First-Episode Psychosis Patients

“…Supporting such an interpretation is that impairments in estrogen- and lipid metabolism have been implicated in the development of and in predicting the severity of schizophrenia ( 3 , 11 , 78 – 83 ). Further support of an estrogen-cholesterol interaction comes from studies of other neurological conditions with a similar sex bias and abnormal cholesterol metabolism, such as Alzheimer's disease ( 84 ) and multiple sclerosis ( 85 ).…”

Advanced Biomarkers: Therapeutic and Diagnostic Targets in Urticaria

“…Vitamin D is an essential molecule to maintain the homeostasis of bones and minerals, and it also has immune regulation functions in the human body. Many studies have shown that vitamin D deficiency is associated with various autoimmune and allergic diseases, such as multiple sclerosis and CU [75,76]. The availability of vitamin D supplements in the treatment of CSU has been confirmed by some small-scale clinical trials [77,78], but the mechanism is still unclear, which may contribute to the pathogenic pathway inhibition of vitamin D-binding protein.…”