Waist Circumference and Body Mass Index as Predictors of Disability Progression in Multiple Sclerosis: A Systematic Review and Meta-Analysis.
Vasileios Giannopapas, Maria-Ioanna Stefanou, Vassiliki Smyrni, Dimitrios K Kitsos, Maria Kosmidou, Sophia Stasi, Athanasios K Chasiotis, Konstantina Stavrogianni, Georgia Papagiannopoulou, John S Tzartos, George P Paraskevas, Georgios Tsivgoulis, Sotirios Giannopoulos
Author Information
Vasileios Giannopapas: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Maria-Ioanna Stefanou: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Vassiliki Smyrni: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Dimitrios K Kitsos: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
Maria Kosmidou: Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.
Sophia Stasi: Biomechanics Laboratory, Department of Physiotherapy, University of Peloponnese, 23100 Sparta, Greece. ORCID
Athanasios K Chasiotis: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
Konstantina Stavrogianni: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
Georgia Papagiannopoulou: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
John S Tzartos: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
George P Paraskevas: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
Georgios Tsivgoulis: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
Sotirios Giannopoulos: Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. ORCID
While obesity has been shown to elevate the risk of developing multiple sclerosis (MS), there is a lack of strong evidence regarding its role in the disability progression and status of MS patients. This systematic review and meta-analysis aimed to provide comparative estimates of WC and BMI in patients with MS (PwMS) and to investigate potential associations between the waist circumference (WC) and body mass index (BMI) and demographic and specific MS characteristics. Adhering to PRISMA guidelines, a detailed search of the MEDLINE PubMed, Cochrane Library, and Scopus databases was conducted. A total of 16 studies were included. The pooled mean WC and BMI among PwMS was estimated to be 87.27 cm (95%CI [84.07; 90.47]) and 25.73 (95%CI [25.15; 26.31]), respectively. Meta-regression models established a significant bidirectional relationship between WC and the Expanded Disability Scale (EDSS) ( < 0.001) but not between BMI and EDSS ( = 0.45). Sensitivity analyses showed no association between WC and age ( = 0.48) and a tendency between WC and disease duration ( = 0.08). Although WC measurements classify PwMS as normal weight, BMI measurements classify them as overweight. Therefore, WC should complement BMI evaluations in clinical practice. Additionally, our findings highlight the significant association between abdominal fat, as indicated by WC, and disease progression. Considering the heightened risk of cardiovascular comorbidity and mortality among PwMS, we recommend integrating both WC and BMI as standard anthropometric measurements in routine clinical examinations and targeted prevention strategies for PwMS.
