The role of fats in the progression of MS

Dr Ingrid van der Mei

Menzies Institute for Medical Research, TAS

January 2012

specialisation: Epidemiology

focus area: Better treatments

funding type: Project

project type: Investigator Led Research

Summary

Fats are an essential component of the brain and contribute to its repair and maintenance. There is now evidence that some fats, such as particular types of cholesterols and triglycerides, are associated with the onset and progression of MS. Dr Van der Mei and colleagues have also discovered that being overweight or obese is associated with a faster progression of MS.

Dr Van der Mei will examine the fat profiles of 198 patients, in blood samples collected 6-monthly over two and a half years for the Tasmanian MS Longitudinal Study. This study is an international data resource with information on relapses, disability, MRI scans, lifestyle, immune function, virology and genetics. Through analysing the samples from this longitudinal study, Dr Van der Mei aims to determine whether an adverse fat profile can influence MS relapses and/or the accumulation of disability in MS.

Furthermore, Dr Van der Mei aims to unravel the key parts of the mechanisms by which fat affects MS progression. She will examine whether the association between an adverse fat profile and clinical disability/relapse rate is modified by, for example, genes known to influence the fat profile and the use of the MS drug, interferon-beta.

Most importantly, the demonstration of an association between certain types of fats and the progression of MS would provide therapeutic opportunities for people with MS such as fat lowering agents and lifestyle modifications (e.g. diet).

Outcome

Lipids have been measured in nearly 1000 samples, including total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, ApoA-I, AapoB, Lp(a) and highly sensitive C-reactive protein. Dr van der Mei and the team first examined which factors were associated serum lipid levels and apolipoproteins. In line with the cardiovascular research, they found that higher body mass index (BMI) was significantly associated with lower HDL cholesterol level and ApoA-I level, and with higher total cholesterol, LDL cholesterol, triglycerides and ApoB. They also found that vitamin D levels were associated with some serum lipids and apolipoproteins.

The team next examined whether BMI and lipids were associated with disability or relapse using a cross-sectional analysis. They found that those who were overweight or obese had a higher clinical disability. Higher total cholesterol, LDL and triglycerides were also significantly associated with a higher level of disability. However, they also found that neither body mass index nor any of the lipid-related measures were associated with the hazard of relapse.

Lastly, Dr van der Mei and the team analysed long term follow-up data to investigate whether BMI and serum lipids were associated with a progression of disability, using a prospective analysis. BMI was not associated with progression. Of the lipids, only HDL and cholesterol was associated with progression in disability.

The scientists also used lag-time modelling to confirm that the associations are not due to reverse causality, i.e. that the changes in lipids are due to MS rather than lipids being a causative factor in the disease.

publications

  • Tettey P, Simpson Jr. SL, Taylor BV, Blizzard L, Ponsonby A-L, Dwyer T, Kostner, K, van der Mei IAF. Lipid profile is not associated with relapse in multiple sclerosis. J Neurol Sci. 2014 May 15;340(1-2):230-2..
  • Tettey P, Simpson Jr. SL, Taylor BV, Blizzard L, Ponsonby A-L, Dwyer T, Kostner, K, van der Mei IAF. An adverse lipid profile is associated with disability and progression in disability in people with MS. Multiple Sclerosis Journal 2014 May 14. pii: 1352458514533162
  • Tettey, P., Simpson Jr, S.L., Taylor, B., Blizzard, L., Ponsonby, A., Dwyer, T., Kostner, K., & van der Mei, I. (2014). No adverse lipid profile predicts the relapses in multiple sclerosis. Journal of the Neurological Sciences. 340(1-2), 230-232.

Updated: 30 June 2014

lead investigator

Dr Ingrid Van Der Mei
Associate Professor Bruce Taylor
Associate Professor Christopher Blizzard
Professor Anne-Louise Ponsonby
Professor Terence Dwyer
Associate Professor Karam Kostner

total funding

$60,000

start year

2012

duration

2 years

STATUS

Past project

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The role of fats in the progression of MS