Background

Fatigue is a frequent symptom in multiple sclerosis (MS). The role of cholesterol and lipids in MS fatigue has not been investigated.

Objective

To investigate the associations of cholesterol biomarkers and serum neurofilament light chain (sNfL) with fatigue in relapsing-remitting MS.

Methods

This cross-sectional study included 75 relapsing-remitting MS patients (69% female, mean age ± SD: 49.6 ± 11 years and median Expanded Disability Status Scale score: 2.0). Fatigue, disability, and depression were assessed with Fatigue Severity Scale (FSS), Expanded Disability Status Scale, and the Beck Depression Index–Fast Screen, respectively. sNfL was measured using single-molecule array technology. Plasma total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and an apolipoprotein panel data were obtained. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), chemokine (C-C motif) ligand 5 (CCL5 or RANTES), and CCL18 levels were measured to assess inflammation.

Results

The mean FSS was 4.27 ± 1.73, and 57% had severe fatigue status (SFS, FSS ≥ 4.0). In regression analyses adjusted for age, sex, disability, and depression, lower FSS and SFS were associated with greater HDL-C (P = .006 for FSS, and P = .016 for SFS) and lower TC to HDL-C ratio (P = .011 for FSS, and P = .009 for SFS). Apolipoprotein A-II was also associated with FSS (P = .022). sNfL, CCL5, CCL18, sICAM-1, and sVCAM-1 levels were not associated with fatigue after adjusting for disability and depression.

Conclusions

TC to HDL-C ratio is associated with MS fatigue. Our results implicate a potential role for the HDL-C pathway in MS fatigue and could provide possible targets for the treatment of MS fatigue.

中文翻译：

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高密度脂蛋白胆固醇与多发性硬化症疲劳有关：疲劳代谢关系？

背景

疲劳是多发性硬化症（MS）的常见症状。尚未研究胆固醇和脂质在MS疲劳中的作用。

客观的

调查胆固醇-生物标志物和血清神经丝轻链（sNfL）与复发-缓解型MS疲劳的关联。

方法

这项横断面研究包括75位复发缓解型MS患者（女性占69％，平均年龄：±SD：49.6±11岁，中度扩展残疾状态量表得分：2.0）。疲劳，残疾和抑郁分别通过疲劳严重程度量表（FSS），扩展残疾状态量表和贝克抑郁指数-快速筛查法进行评估。使用单分子阵列技术测量sNfL。获得血浆总胆固醇（TC），高密度脂蛋白胆固醇（HDL-C）和载脂蛋白面板数据。测量可溶性细胞间粘附分子-1（sICAM-1），可溶性血管粘附分子-1（sVCAM-1），趋化因子（CC基序）配体5（CCL5或RANTES）和CCL18水平以评估炎症。

结果

平均FSS为4.27±1.73，其中57％具有严重疲劳状态（SFS，FSS≥4.0）。在回归分析调整年龄，性别，残疾，和抑郁症，降低FSS和SFS用更大的HDL-C（相关联的P  = 0.006对于FSS，和P  = 0.016为SFS）和降低TC与HDL-C比率（P  = 0.011对于FSS，和P  = 0.009为SFS）。载脂蛋白A-II也与FSS有关（P  = .022）。调整残障和抑郁症后，sNfL，CCL5，CCL18，sICAM-1和sVCAM-1水平与疲劳无关。

结论

TC与HDL-C的比率与MS疲劳有关。我们的结果暗示了HDL-C途径在MS疲劳中的潜在作用，并可能为MS疲劳的治疗提供可能的靶标。