Changes in cholesterol metabolism may be linked to the progression of multiple sclerosis (MS) illness. However, there are many crucial issues that have still to be solved in order to demonstrate the causal link. The purpose of this study was to examine whether or not multiple sclerosis patients who have had brain MRI imaging also have had blood lipid measurements taken. Researchers enrolled 1,505 MS patients (across all MS phenotypes) in this big longitudinal research since they had access to their paired MRI and blood lipid levels (n=4,966 pairs; time difference <3 months). One 1.5-T MRI scanner was used for all patients (Gyroscan, Phillips). ScanView software was used to analyze the volumes of the whole brain and the T2 lesion. Total cholesterol, low density-lipoprotein cholesterol (LDL-C), high density-lipoprotein cholesterol (HDL-C), and triacylglycerol (TAG) were acquired in standard clinical practice to create lipid profiles. Cross-sectional analysis at baseline was done using adjusted linear regression model. The connection between imaging and lipid measurements was analyzed using linear mixed models (with random intercept for patient) with adjustments for sex, age, illness duration, EDSS, treatment status at visit, and time between MRI scans. About 70%  of the participants were female, the average age was 35.9 (SD=9.77), the average duration of illness was 8.02 (SD=7.20), the median EDSS was 2.0 (IQR=2.0,3.0), and the average period of follow-up was 7.7 years. Some 17.1% of patients were not receiving any immunomodulatory therapy, while 72.3% were receiving first-line immunomodulatory treatments and 10.6% were receiving second-line immunomodulatory therapies. In longitudinal mixed model analysis, researchers identified a connection between brain parenchymal fraction (BPF) and HDL-C (b=-0.5; 95% CI: -0.51, -0.27; P=<0.001). There were significant correlations between BPF and both LDL-C (b=0.25; P=0.001) and HDL-C (b=-0.52; P=0.0012) at baseline. They also discovered correlations between (log+1) EDSS and HDL-C (b=-0.07; P=0.008) and TAG (b=0.027; P=0.011). Whole brain volume and blood lipid variations in multiple sclerosis patients are linked in this large longitudinal real-world cohort. Additional research is necessary to determine whether or not this correlation is just coincidental.


Reference: ECTRIMS 2022