'Bad’ fats major culprit in MS progression

'Bad’ fats major culprit in MS progression

Researchers from the Menzies Research Institute Tasmania have found adverse levels of 'bad' fats in the blood are closely linked to the level of disability in people with multiple sclerosis (MS) and the rate of disability progression.

These significant findings just published in the Multiple Sclerosis Journal* suggest dietary and lifestyle modifications that improve fat profiles in the blood may also slow the rate of disability progression in MS.

Menzies is an institute of the University of Tasmania. The lead researcher on the study, Dr Ingrid van der Mei (above), says: "This is a very significant finding for the 23,000 Australians living with MS - as it shows reducing bad fats may improve clinical outcomes and vascular comorbidities. Our new findings indicate that clinicians should monitor and treat adverse lipid profiles in Australians living with MS."

Fats are an essential component of the brain and contribute to its repair and maintenance. Growing evidence now suggests that with MS some 'bad' fats - that are usually associated with poor cardiovascular health and including particular types of cholesterol and triglycerides - are linked to the progression of the condition.

This particular study examined the fat profiles from blood samples of 141 people with relapsing remitting MS. The samples were collected at six monthly intervals over two and a half years as part of the NHMRC funded Tasmanian MS Longitudinal Study. This study is a highly valuable long-term data resource with detailed information on relapses, disability, MRI scans, lifestyle, immune function, virology and genetics.

The results showed the amounts of a number of different fats in the blood, including total cholesterol, were closely associated with disability level as measured by the Expanded Disability Status Score (EDSS). This association remained strong even when other potentially confounding factors such as smoking, exercise, age and sex were taken into account.

The yearly change in disability level of each patient was also assessed in relation to fat levels over the period of the study. This indicated that a higher rate of disability progression was also associated with higher total cholesterol levels relative to levels High Density Lipoproteins (HDL) (the TC/HDL ratio).

However, fat levels did not have any influence on the risk of experiencing a relapse for the people in the study and body mass index (a measure calculated from weight and height to determine obesity levels) was also not related to relapses.

This suggests that rather than influencing the inflammatory processes that underlie relapses in MS, the fats in the blood may instead influence ongoing degeneration of brain tissue that drives the progressive phase of the disease.

The researchers looked at the levels of physical activity and used time-lag modelling of the data, but could find no evidence for 'reverse causality' - i.e. that faster progression of disability leads to a higher BMI and higher fat levels in the blood.

The researchers suggest reducing lipids, decreas­ing BMI into the healthy range and increasing physical activity may significantly reduce the accumulation of disability for people with MS. Further clinical studies are recommended to confirm that such interventions can slow disability progression.

This research has been funded by MS Research Australia (via a project grant in 2012) http://www.msra.org.au/role-fats-progression-multiple-sclerosis to investigate whether fats play a role in the risk of relapses in MS and disability progression.

*An adverse lipid profile is associated with disability and progression in disability, in people with MS. Multiple Sclerosis Journal: http://msj.sagepub.com/content/early/2014/05/14/1352458514533162

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