The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (Jan 2020)
Impact of insulin resistance and metabolic syndrome on disability in patients with multiple sclerosis
Abstract
Abstract Background Currently, little is known regarding the association of metabolic comorbidities and disability among multiple sclerosis (MS) patients. Objectives To evaluate insulin resistance (IR) and metabolic syndrome (MetS) in multiple sclerosis patients and their effect on disease progression and disability. Subjects and methods This case-control study was conducted on 50 MS patients and 25 healthy individuals. They were subjected to clinical evaluation and laboratory assessment for metabolic syndrome and insulin resistance. The homeostasis model assessment (HOMA) was used as a measurement of insulin sensitivity. Disability was evaluated by the Extended Disability Status Scale (EDSS). Results As compared to control group, MS patients had a significantly higher prevalence of metabolic syndrome (22% vs 8%, p = 0.04) and insulin resistance (46% vs 0%, p < 0.001). Patients group had significantly higher systolic blood pressure (p = 0.005), waist circumference (p < 0.001), fasting blood sugar (p < 0.001), insulin level (p = 0.001), low-density lipoproteins (p = 0.01), triglycerides (p = 0.02), HOMA-IR (p < 0.001), and significantly lower high-density lipoproteins (p = 0.01). No differences in neurological disability was reported between patients who have MetS (p = 0.7) or IR (p = 0.3) and those who do not. Conclusion Insulin resistance and metabolic syndrome are more prevalent among MS patients; however, their association with disability and disease progression is questionable.
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