Obesity is associated with myelin oligodendrocyte glycoprotein antibody-associated disease in acute optic neuritis

Stiebel-Kalish, H.; Rubarth, K.; Shouchane-Blum, K.; Tiosano, A.; Lotan, I.; Hellmann, M.A.; Wilf-Yarkoni, A.; Bialer, O.; Flanagan, E.P.; Pittock, S.J.; Bhatti, M.T.; Schmitz-Hübsch, T.; Paul, F.; Asseyer, S.; Chen, J.J.

Obesity is associated with myelin oligodendrocyte glycoprotein antibody-associated disease in acute optic neuritis

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Item Type:	Article
Title:	Obesity is associated with myelin oligodendrocyte glycoprotein antibody-associated disease in acute optic neuritis
Creators Name:	Stiebel-Kalish, H., Rubarth, K., Shouchane-Blum, K., Tiosano, A., Lotan, I., Hellmann, M.A., Wilf-Yarkoni, A., Bialer, O., Flanagan, E.P., Pittock, S.J., Bhatti, M.T., Schmitz-Hübsch, T., Paul, F., Asseyer, S. and Chen, J.J.
Abstract:	Optic neuritis (ON) is a frequent presentation at onset of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The pathophysiology underlying these diseases, especially MOGAD, is still being elucidated. While obesity has been reported to potentially be a risk factor for MS, this has not been explored in NMOSD or MOGAD. We aimed to investigate a possible association between obesity (body mass index [BMI] > 30 kg/m(2)) in patients with MOGAD, aquaporin 4-IgG positive NMOSD (AQP4-IgG+ NMOSD) or MS. In this multicenter non-interventional retrospective study, data was collected from patients with a first ever demyelinating attack of ON subsequently diagnosed with MOGAD (n = 44), AQP4-IgG+ NMOSD (n = 49) or MS (n = 90) between 2005 and 2020. The following data was collected: age, sex, ethnicity, BMI (documented before corticosteroid treatment), and the ON etiology after diagnostic work-up. A mixed model analysis was performed to assess the potential of obesity or BMI to predict MOGAD-ON, and to distinguish MOGAD-ON from AQP4-IgG+ NMOSD-ON and MS-ON. Main outcome measures included BMI in patients with acute ON and subsequent diagnosis of MOGAD, AQP4-IgG+ NMOSD or MS. A higher BMI was significantly associated with a diagnosis of MOGAD-ON (p < 0.001); in MOGAD patients the mean BMI was 31.6 kg/m(2) (standard deviation (SD) 7.2), while the mean BMI was 24.7 kg/m(2) (SD 5.3) in AQP4-IgG+ NMOSD patients, and 26.9 kg/m(2) (SD 6.2) in MS patients. Mixed-effects multinomial logistic regression, adjusted for age and sex, with obesity as a binary variable, revealed that obesity was associated with a higher odds ratio (OR) of a subsequent MOGAD diagnosis (OR 5.466, 95% CI [2.039, 14.650], p = 0.001) in contradistinction with AQP4-IgG+ NMOSD. This study suggests an association between obesity and MOGAD. Our findings require further exploration, but could have significant pathophysiologic implications if confirmed in larger prospective studies.
Keywords:	Aquaporin 4, Autoantibodies, Immunoglobulin G, Multiple Sclerosis, Myelin-Oligodendrocyte Glycoprotein, Neuromyelitis Optica, Obesity, Optic Neuritis, Prospective Studies, Retrospective Studies
Source:	Scientific Reports
ISSN:	2045-2322
Publisher:	Nature Publishing Group
Volume:	12
Number:	1
Page Range:	21312
Date:	9 December 2022
Additional Information:	Erratum in: Sci Rep 13, 2944 (2023)
Official Publication:	https://doi.org/10.1038/s41598-022-21592-8
PubMed:	View item in PubMed

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