1
|
Gauthier H, Zedet M, Wahab A, Baldé S, Bapst B, Lafont C, Créange A. Metabolic syndrome and the phenotype of multiple sclerosis. Rev Neurol (Paris) 2024:S0035-3787(24)00502-2. [PMID: 38729781 DOI: 10.1016/j.neurol.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Comorbidities, particularly vascular comorbidities, have been shown to exacerbate the progression of disability in multiple sclerosis (MS). Metabolic syndrome (MetS) is a cluster of conditions including abdominal obesity, insulin resistance, atherogenic dyslipidemia, and vascular dysfunction, which contribute to vascular morbidity and chronic inflammation. OBJECTIVE To describe the characteristics of MetS in a cohort of MS patients and evaluate its relationship with the MS phenotype. METHODS A monocentric cohort study was conducted on MS patients, collecting demographic, clinical, radiological, and therapeutic data, as well as metabolic data including waist circumference, blood pressure, serum triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. RESULTS Among the 84 patients included in the study, 27% were diagnosed with MetS. MetS was found to be associated with secondary progressive MS (SPMS). Patients with SPMS had a higher prevalence of MetS compared to those with relapsing-remitting MS (RRMS), even after adjusting for disease duration. While MetS was associated with Expanded Disability Status Scale (EDSS) progression in the 3-year period according to univariate analysis, it did not show a significant association with disease activity. CONCLUSION This study provides evidence supporting the connection between MetS and the progression of disability in MS, independent of disease relapse activity.
Collapse
Affiliation(s)
- H Gauthier
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - M Zedet
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France
| | - A Wahab
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France
| | - S Baldé
- CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - B Bapst
- EA4391, université Paris-Est, Créteil, France; Service de neuroradiologie, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - C Lafont
- IMRB, Inserm, université Paris-Est-Créteil, 94010 Créteil, France; Service de santé publique, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France
| | - A Créange
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France.
| |
Collapse
|
2
|
Bowo-Ngandji A, Kenmoe S, Ebogo-Belobo JT, Kenfack-Momo R, Takuissu GR, Kengne-Ndé C, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Lontuo Fogang R, Zeuko'o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Wandji Nguedjo M, Assam Assam JP, Enyegue Mandob D, Ngondi JL. Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis. PLoS One 2023; 18:e0289155. [PMID: 37498832 PMCID: PMC10374159 DOI: 10.1371/journal.pone.0289155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations. METHODS A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study. RESULTS In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6). CONCLUSION This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.
Collapse
Affiliation(s)
- Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Institute of Medical Research and Medicinal Plants Studies, Medical Research Centre, Yaounde, Cameroon
| | | | - Maxwell Wandji Nguedjo
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | | |
Collapse
|
3
|
Giannopapas V, Palaiodimou L, Kitsos D, Papagiannopoulou G, Stavrogianni K, Chasiotis A, Kosmidou M, Tzartos JS, Paraskevas GP, Bakalidou D, Tsivgoulis G, Giannopoulos S. The Prevalence of Diabetes Mellitus Type II (DMII) in the Multiple Sclerosis Population: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:4948. [PMID: 37568348 PMCID: PMC10420178 DOI: 10.3390/jcm12154948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Introduction: The interactions between Diabetes Mellitus type II (DMII) and Multiple Sclerosis (MS) lead to higher levels of fatigue, higher risk of physical disability, faster cognitive decline, and in general a lower quality of life and a higher frequency of depression compared to the general population. All of the above accelerate the disability progression of patients with MS, reduce the patients' functional capacity, and further increase their psychological and economic burden. Methods: This systematic review and meta-analysis aims to calculate the prevalence of DMII in the MS population. Following PRISMA guidelines, a thorough search of the Medline Pubmed, Cochrane Library, and Scopus databases was performed, focusing on the frequency of DMII in the MS population. Results: A total of 19 studies were included in the synthesis. The results of the main meta-analysis of random effects using R studio 3.3.0 for Windows and the Meta r package showed that the prevalence of DMII in the MS population is 5% (95% CI [0.03, 0.07], 19 studies, I2 = 95%, pQ < 0.001). Additional subgroup analysis based on region showed a difference of 4.4% (I2 = 95.2%, pQ < 0.001), psubgroupdifference = 0.003) between European and non-European participants, while demographic- and MS-specific characteristic (EDSS, Disease Duration) did not seem to affect the prevalence of DMII in the MS population (p = 0.30, p = 0.539, p = 0.19, p = 0.838). No publication bias was discovered (Egger's p test value: 0.896). Conclusions: Even though the prevalence of DMII in the MS population is lower than 10% (the reported prevalence of DMII in the general population) the interactions between the two conditions create significant challenges for MS patients, their caregivers, and physicians. DΜΙΙ should be systematically recorded in the case of MS patients to clearly delineate any potential relationship between the two conditions. Additionally, more structured studies investigating the interactions of MS and DMΙΙ as well as the direction of the causation between those two conditions are necessary in order to gain a deeper insight into the nature of the interaction between MS and DMII.
Collapse
Affiliation(s)
- Vasileios Giannopapas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Lina Palaiodimou
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Dimitrios Kitsos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Georgia Papagiannopoulou
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Konstantina Stavrogianni
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Department of Physiology, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece
| | - Athanasios Chasiotis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Maria Kosmidou
- Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece;
| | - John S. Tzartos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - George P. Paraskevas
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Daphne Bakalidou
- Physical Therapy Department, University of West Attica, 12210 Athens, Greece;
- Laboratory of Neuromuscular and Cardiovascular Study of Motion (Lanecasm), 12243 Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| | - Sotirios Giannopoulos
- Second Department of Neurology, Attikon University Hospital, School of Medicine, National & Kapodistrian University of Athens, 15784 Athens, Greece; (V.G.); (L.P.); (G.P.); (K.S.); (A.C.); (J.S.T.); (G.P.P.); (G.T.)
| |
Collapse
|
4
|
Hardoňová M, Šiarnik P, Siváková M, Suchá B, Vlček M, Imrich R, Turčáni P, Havranová A, Rádiková Ž, Žitňanová I, Dean Z, Penesová A, Kollár B. Autonomic Nervous System Function in Newly Diagnosed Multiple Sclerosis: Association With Lipid Levels and Insulin Resistance. Physiol Res 2021; 70:875-882. [PMID: 34717060 DOI: 10.33549/physiolres.934695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Autonomic nervous system (ANS) disorders are common in multiple sclerosis (MS). Previous studies showed differences in insulin resistance (IR) and lipoprotein levels in MS subjects compared to controls. Lipolysis caused by increased sympathetic activity could be one of the possible linking mechanisms leading to dyslipidemia in MS. Our study aimed to evaluate ANS activity in the context of glucose and lipid metabolism in people with MS. We prospectively measured short-term heart rate variability (HRV), fasting lipoprotein concentrations, and calculated IR indices based on plasma glucose and insulin levels during oral glucose tolerance test (oGTT) in 32 patients with MS and 29 healthy controls matched for age, sex and body mass index in our study. There was no significant difference in HRV parameters and lipoprotein levels between MS and controls. A significant positive correlation was found between low/high-frequency power ratio (LF/HF) and triglycerides (r=0.413, p=0.021) in MS subjects but not in controls. A significantly lower whole-body insulin sensitivity index (ISIMat) was found in patients with MS compared to the control group (7.3±3.7 vs. 9.8±5.6, p=0.041). No significant correlations were found between LF/HF and IR parameters. In MS subjects, the positive correlation of LF/HF with triglycerides could reflect the effects of sympathetic activity on lipolysis. Positive correlations of sympathetic activity with increased lipoprotein levels could rather reflect processes associated with immune system activation/inflammation, than processes involved in glucose homeostasis maintenance.
Collapse
Affiliation(s)
- M Hardoňová
- 1st Department of Neurology, Faculty of Medicine, Comenius University, Slovakia.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Siokas V, Katsiardanis K, Aloizou AM, Bakirtzis C, Liampas I, Koutlas E, Rudolf J, Ntinoulis K, Kountouras J, Dardiotis E, Deretzi G. Impact of Body Mass Index on the Age of Relapsing-Remitting Multiple Sclerosis Onset: A Retrospective Study. Neurol Int 2021; 13:517-26. [PMID: 34698268 DOI: 10.3390/neurolint13040051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 12/25/2022] Open
Abstract
A BACKROUND: Multiple sclerosis (MS) is a complex chronic disease of the central nervous system (CNS). Body mass index (BMI), a component of metabolic syndrome (MetS), is considered among the risk factors for MS. However, its role in MS remains ambiguous. OBJECTIVE: To examine the impact of BMI on the age of onset in patients with relapsing-remitting MS (RRMS) in a Greek cohort. METHODS: Data from 821 Greek patients with RRMS were collected. The BMI values were considered as quartiles. Comparisons for the demographic characteristics between the quartiles were made by Pearson’s chi-square test for the categorical variables and by ANOVA for the continuous variables. An overall p-value was calculated corresponding to trend for association. In case of significant association, further post-hoc analysis was performed in order to identify differences in demographic characteristics between specific BMI quartiles groups. Linear regression analyses were used to assess the relationship between BMI and age at onset of MS. RESULTS: Comparisons of participant characteristics by quartiles of BMI revealed that participants with the highest BMI had an older age of disease onset. Results from linear regression analysis showed that with each increase of 1 BMI unit, the age of RRMS onset increases by 0.255 (95% CI 0.136 to 0.374) years, p < 0.001. CONCLUSIONS: Patients with higher BMI, as a parameter of MetS, exhibit increased age of RRMS onset. Our results may present an alternative personalized approach for diagnosis, prognosis, and/or prevention of RRMS.
Collapse
|
6
|
Wang FX, Zhu N, Zhou F, Lin DX. Natural Aporphine Alkaloids with Potential to Impact Metabolic Syndrome. Molecules 2021; 26:molecules26206117. [PMID: 34684698 PMCID: PMC8540223 DOI: 10.3390/molecules26206117] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/25/2021] [Accepted: 10/06/2021] [Indexed: 12/28/2022] Open
Abstract
The incidence and prevalence of metabolic syndrome has steadily increased worldwide. As a major risk factor for various diseases, metabolic syndrome has come into focus in recent years. Some natural aporphine alkaloids are very promising agents in the prevention and treatment of metabolic syndrome and its components because of their wide variety of biological activities. These natural aporphine alkaloids have protective effects on the different risk factors characterizing metabolic syndrome. In this review, we highlight the activities of bioactive aporphine alkaloids: thaliporphine, boldine, nuciferine, pronuciferine, roemerine, dicentrine, magnoflorine, anonaine, apomorphine, glaucine, predicentrine, isolaureline, xylopine, methylbulbocapnine, and crebanine. We particularly focused on their impact on metabolic syndrome and its components, including insulin resistance and type 2 diabetes mellitus, endothelial dysfunction, hypertension and cardiovascular disease, hyperlipidemia and obesity, non-alcoholic fatty liver disease, hyperuricemia and kidney damage, erectile dysfunction, central nervous system-related disorder, and intestinal microbiota dysbiosis. We also discussed the potential mechanisms of actions by aporphine alkaloids in metabolic syndrome.
Collapse
Affiliation(s)
- Fei-Xuan Wang
- Nanjing Institute of Product Quality Inspection, Nanjing 210019, China; (N.Z.); (F.Z.); (D.-X.L.)
- Correspondence: ; Tel.: +86-13505140525
| | - Nan Zhu
- Nanjing Institute of Product Quality Inspection, Nanjing 210019, China; (N.Z.); (F.Z.); (D.-X.L.)
| | - Fan Zhou
- Nanjing Institute of Product Quality Inspection, Nanjing 210019, China; (N.Z.); (F.Z.); (D.-X.L.)
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Dong-Xiang Lin
- Nanjing Institute of Product Quality Inspection, Nanjing 210019, China; (N.Z.); (F.Z.); (D.-X.L.)
| |
Collapse
|
7
|
Schreiner TG, Genes TM. Obesity and Multiple Sclerosis-A Multifaceted Association. J Clin Med 2021; 10:2689. [PMID: 34207197 DOI: 10.3390/jcm10122689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/30/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Given the common elements in the pathophysiological theories that try to explain the appearance and evolution of obesity and multiple sclerosis, the association between the two pathologies has become an increasingly researched topic in recent years. On the one hand, there is the chronic demyelinating inflammation caused by the autoimmune cascade of multiple sclerosis, while on the other hand, according to the latest research, it has been shown that obesity shares an inflammatory component with most chronic diseases. METHODS The authors performed independent research of the available literature in the most important electronic databases (PubMed, Google Scholar, Embase, and Science Direct) in February 2021. After applying the exclusion criteria, the reviewers focused on the most relevant articles published during the last 10 years with respect to epidemiology and pathophysiology. RESULTS The data presented are a step forward in trying to elucidate the intricate relationship between obesity and MS, especially the causal relationship between childhood and adolescent obesity and MS, focusing on the epidemiological associations observed in the most relevant observational studies conducted in recent years. In the second part, the authors comment on the latest findings related to the pathophysiological mechanisms that may explain the correlations between obesity and multiple sclerosis, focusing also on the role of adipokines. CONCLUSIONS Based on available epidemiological data, obesity in early life appears to be strongly associated with a higher risk of MS development, independent of other risk factors. Although much research has been done on the pathophysiology of obesity, MS, their possible common mechanism, and the role of adipokines, further studies are needed in order to explain what remains unknown. No relevant data were found regarding the association between obesity, disability (high EDSS score), and mortality risk in MS patients. Thus, we consider that this topic should be elucidated in future research.
Collapse
|