BACKGROUND Smoking and obesity are recognized modifiable risk factors associated with a higher MS incidence, but their impact on physical and cognitive disability worsening is less clear. OBJECTIVE To investigate the impact of smoking and obesity on disability worsening in primary progressive MS (PPMS). METHODS We used data from INFORMS (clinicaltrials.gov identifier: NCT00731692), a large randomized-controlled trial in PPMS to compare significant worsening on the EDSS, T25FW, NHPT, and PASAT between smokers and non-smokers, and between BMI groups, at 12, 24, and 33 months of follow-up. We investigated the association of smoking and BMI at screening and the risk of disability worsening with logistic regression models. RESULTS Smokers had significantly higher EDSS scores throughout the trial. EDSS was not significantly different between BMI categories. No other outcome measure was significantly different between smokers and non-smokers and between BMI categories throughout the trial. Neither smoking status nor BMI were associated with significant worsening on any outcome measure at any time point during follow-up. CONCLUSION Despite the known effects on MS incidence, smoking and BMI were not associated with the risk of physical and cognitive disability worsening over 3 years in this well-characterized PPMS trial cohort.

中文翻译：

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PPMS 中的吸烟、肥胖和残疾恶化：对 INFORMS 原始试验数据集的分析。

背景 吸烟和肥胖是公认的与 MS 发病率较高相关的可改变风险因素，但它们对身体和认知残疾恶化的影响尚不清楚。目的探讨吸烟和肥胖对原发性进行性多发性硬化症（PPMS）残疾恶化的影响。方法 我们使用来自 INFORMS 的数据（clinicaltrials.gov 标识符：NCT00731692），这是一项大型的 PPMS 随机对照试验，比较吸烟者和非吸烟者之间以及 BMI 组之间 EDSS、T25FW、NHPT 和 PASAT 的显着恶化情况，在12、24 和 33 个月的随访。我们使用逻辑回归模型调查了筛查时吸烟和 BMI 的关联以及残疾恶化的风险。结果 在整个试验过程中，吸烟者的 EDSS 得分明显更高。BMI 类别之间的 EDSS 没有显着差异。在整个试验期间，吸烟者和非吸烟者之间以及 BMI 类别之间没有其他结果测量有显着差异。在随访期间的任何时间点，吸烟状况和 BMI 均与任何结果测量的显着恶化无关。结论 尽管已知对 MS 发病率的影响，吸烟和 BMI 在这个特征明确的 PPMS 试验队列中与 3 年内身体和认知障碍恶化的风险无关。