Disability in patients with multiple sclerosis: influence of insulin resistance, adiposity, and oxidative stress.
OBJECTIVE
The aims of the present study were to report the prevalence of insulin resistance (IR) in patients with multiple sclerosis (MS); to verify differences in metabolic and inflammatory biomarkers, and oxidative stress in patients with MS with or without IR; and to assess if IR and adiposity are associated with disability in these patients.


METHODS
The study enrolled 110 patients with MS and 175 healthy individuals. Patients with MS were divided in those with IR (n = 44) and those without (n = 66). Metabolic and inflammatory markers, oxidative stress, and disability were evaluated by the Extended Disability Status Scale (EDSS).


RESULTS
IR prevalence was verified in 40% of the patients with MS and in 21.1% of the control group (odds ratio, 2.48; 95% confidence interval, 1.469-4.210; P = 0.0006). Patients with the disease and IR showed higher EDSS (P = 0.031), interleukin (IL)-6 (P = 0.028), IL-17 (P = 0.006), oxidative stress evaluated by tert-butyl hydroperoxide-initiated chemiluminescence (P = 0.029), and advanced oxidation protein products (P = 0.025) than those patients without IR. The multivariate analysis showed that disability was associated with IR evaluated by homeostasis model assessment of insulin resistance (P = 0.030) and adiposity evaluated by waist circumference (P = 0.0179) and body mass index (P = 0.0033).


CONCLUSION
This is the first study to demonstrate an increase IR prevalence and the association between IR and adiposity with disability assessed by EDSS in patients with MS. IR seems to be associated with chronic inflammatory process and oxidative stress in patients with MS. More studies are warranted to elucidate the mechanisms by which IR and adiposity could contribute to the progression and disability in patients with MS.
['Oliveira|Sayonara Rangel|SR|', 'Simão|Andréa Name Colado|AN|', 'Kallaur|Ana Paula|AP|', 'de Almeida|Elaine Regina Delicato|ER|', 'Morimoto|Helena Kaminami|HK|', 'Lopes|Josiane|J|', 'Dichi|Isaias|I|', 'Kaimen-Maciel|Damácio Ramon|DR|', 'Reiche|Edna Maria Vissoci|EM|']
D050154:Adiposity D000328:Adult D000886:Anthropometry D015415:Biomarkers D001794:Blood Pressure D001823:Body Composition D015992:Body Mass Index D003430:Cross-Sectional Studies D003924:Diabetes Mellitus, Type 2 D005260:Female D006801:Humans D007333:Insulin Resistance D020381:Interleukin-17 D015850:Interleukin-6 D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D009765:Obesity D018384:Oxidative Stress D015995:Prevalence D055105:Waist Circumference
Multiple sclerosis Insulin resistance Oxidative stress EDSS Cytokines