Body mass index trajectories in pediatric multiple sclerosis

J Nicholas Brenton, Emma Woolbright, Christina Briscoe-Abath, Asma Qureshi, Mark Conaway, Myla D Goldman, J Nicholas Brenton, Emma Woolbright, Christina Briscoe-Abath, Asma Qureshi, Mark Conaway, Myla D Goldman

Abstract

Aim: To characterize growth trajectories of children who develop multiple sclerosis compared to typically developing, regional peers and Centers for Disease Control (CDC) normative values.

Method: This case-control study collected weight, height, and body mass index (BMI) in 40 consecutive pediatric patients with multiple sclerosis (28 females, 12 males), in addition to 120 typically developing peers (84 females, 36 males), identified and matched for year of birth, sex, ethnicity, and socio-economic status. BMI values were converted to z-scores based on CDC reference values and were compared with respect to age between our two cohorts and by years relative to multiple sclerosis onset for cases.

Results: Median age for the clinical onset of multiple sclerosis was 15 years. BMI z-scores are significantly higher for patients with multiple sclerosis compared to typically developing, demographically-matched peers and CDC standards. These significant differences in BMI are noted from 4 years of age and onward. Height trajectories were similar among case and control individuals and CDC normative values.

Interpretation: BMI in pediatric multiple sclerosis is markedly higher, beginning in early childhood, years before the clinical-onset of the disease.

What this paper adds: Children with multiple sclerosis are significantly more overweight than typically developing peers at the time of diagnosis. Body mass index trajectories are significantly higher years before the clinical manifestation(s) of multiple sclerosis.

© 2019 Mac Keith Press.

References

    1. Chitnis T, Glanz B, Jaffin S, Healy B. Demographics of pediatric-onset multiple sclerosis in an MS center population from the Northeastern United States. Mult Scler 2009; 15: 627-31.
    1. Mowry EM, Krupp LB, Milazzo M, et al. Vitamin D status is associated with relapse rate in pediatric-onset multiple sclerosis. Ann Neurol 2010; 67: 618-24.
    1. Mikaeloff Y, Caridade G, Tardieu M, Suissa S; KIDSEP study group. Parental smoking at home and the risk of childhood-onset multiple sclerosis in children. Brain 2007; 130: 2589-95.
    1. Banwell B, Bar-Or A, Arnold DL, et al. Clinical, environmental, and genetic determinants of multiple sclerosis in children with acute demyelination: a prospective national cohort study. Lancet Neurol 2011; 10: 436-45.
    1. Alotaibi S, Kennedy J, Tellier R, Stephens D, Banwell B. Epstein-Barr virus in pediatric multiple sclerosis. JAMA 2004; 291: 1875-9.
    1. Pohl D, Krone B, Rostasy K, et al. High seroprevalence of Epstein-Barr virus in children with multiple sclerosis. Neurology 2006; 67: 2063-5.
    1. Langer-Gould A, Brara SM, Beaber BE, Koebnick C. Childhood obesity and risk of pediatric multiple sclerosis and clinically isolated syndrome. Neurology 2013; 80: 548-52.
    1. Chitnis T, Graves J, Weinstock-Guttman B, et al. Distinct effects of obesity and puberty on risk and age at onset of pediatric MS. Ann Clin Transl Neurol 2016; 3: 897-907.
    1. Munger KL, Chitnis T, Ascherio A. Body size and risk of MS in two cohorts of US women. Neurology 2009; 73: 1543-50.
    1. Hedström AK, Olsson T, Alfredsson L. High body mass index before age 20 is associated with increased risk for multiple sclerosis in both men and women. Mult Scler 2012; 18: 1334-6.
    1. Wisse BE. The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol 2004; 15: 2792-800.
    1. Sanna V, Di Giacomo A, La Cava A, et al. Leptin surge precedes onset of autoimmune encephalomyelitis and correlates with development of pathogenic T cell responses. J Clin Invest 2003; 111: 241-50.
    1. Brenton JN, Koenig S, Goldman MD. Vitamin D status and age of onset of demyelinating disease. Mult Scler Relat Disord 2014; 3: 684-8.
    1. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011; 69: 292-302.
    1. Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 2013; 19: 1261-7.
    1. Center for Disease Control. Healthy weight, 2015. . (accessed 19 May 2016).
    1. Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 1992; 11: 1305-19.
    1. Gianfrancesco MA, Stridh P, Rhead B, et al. Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS. Neurology 2017; 88: 1623-9.
    1. Weiland TJ, Jelinek GA, Marck CH, et al. Clinically significant fatigue: prevalence and associated factors in an international sample of adults with multiple sclerosis recruited via the internet. PLoS ONE 2015; 10: e0115541.
    1. Brenton JN, Koshiya H, Engel CE, Herrod S, Engelhard M, Goldman MD. Utility of physical disability outcome measures in pediatric-onset multiple sclerosis. Neurology 2017; 88(16 Suppl): P1.353.
    1. Brenton JN, Woolbright E, Koshiya H, Engelhard M, Goldman MD. Continuous accelerometry as a measure of physical activity impairment in paediatric-onset multiple sclerosis participants versus healthy controls. ECTRIMS Online Libr 2017; 2017: 199974.

Source: PubMed

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