Researchers say high lipid levels can lead to inflammation and disability in MS patients.
Why should a person with multiple sclerosis be concerned about their lipid levels?
For starters, their heart health and their quality of life might depend on it.
A recent study demonstrated how high lipid levels in people with multiple sclerosis (MS) can cause inflammation and disability.
Lipoproteins are a combination of lipids (fats) — triglycerides, cholesterol, and phospholipids — and protein.
When the fat ratio is higher than protein the substances become less dense and result in very low density lipoprotein (VLDL).
Other fat to protein ratios create low density (LDL) and high density (HDL) lipoproteins, commonly associated with cholesterol.
“We have long known that MS is a disease that involves far more than central nervous system (brain, spinal, and cord),” Paul Matthews, a study co-author and a professor of clinical neurosciences at the Imperial College London in the United Kingdom, told Healthline, “We also have recognized that there is a link to vascular disease and metabolic syndrome.”
The study showed increases in both VLDL and HDL cholesterol in MS patients compared to a control group.
The bad cholesterol subtype level, called the VLDL biomarker, also showed a small connection with disabilities.
“This small study is congruent with other research which has indicated that vascular co-morbidities are associated with worse neurologic status in a person with MS, and that serum lipid profile in persons with MS can be correlated with disability,” Dr. Barbara Giesser, professor of clinical neurology at the David Geffen School of Medicine at the University of California Los Angeles (UCLA) and clinical director of the UCLA MS program, told Healthline.
The researchers from London included 27 patients living with relapsing remitting multiple sclerosis (RRMS) and another 31 in the control group. Those on statins therapies were excluded from analysis.
“The data from this study helps us to understand some of the molecules and pathways that may be responsible for these relationships. This is the first step toward exploring how medicines that modify blood lipids could contribute to better management of MS,” said Matthews.
Giesser shared limitations to the study including its small size, the fact it wasn’t controlled for diet, and the blood samples were non-fasting.
“However, it adds to the growing body of data supporting the importance of diet and lifestyle as a part of the optimal management of persons with MS,” she said. “It is worth further studying.”
Blood work such as this might prove to be quite beneficial in diagnosing and managing multiple sclerosis.
“Biomarkers may be a more sensitive readout for diagnostic information or disease activities. Better than some current options,” Mark Allegretta, PhD, associate vice president of commercial research for the National Multiple Sclerosis Society, told Healthline.
“This method takes advantage of fine-tuned ways to look at subtraction of lipoproteins,” he explained, “It would nice if there were tools more sensitive as an earlier indicator for worsening disabilities. A fine-tuned detection method could show disability prior to clinical presentation, which could be very useful.”
“Using biomarkers to identify when to switch therapies could help in the precision medicine field tailoring to the individual,” Allegretta said. “It is too early to say if there is diagnostic use for this. More studies are needed. But, they have identified new markers that could be tools in precision medicine space.”
“These results provide rational connecting lipoprotein markers thought to be important in the cardiovascular world,” Allegretta added.
Matthews said the lipid effects could also reach the brain.
“We are testing whether changes in these or related molecules may be responsible for the apparently beneficial effects of simvastatin in people with progressive MS,” said Matthews.
A phase II study, MS STAT, found that after two years of taking simvastatin there was less brain atrophy or shrinkage.
This brain shrinkage has been associated with disability and impairment.
“Great progress has been made in MS research over the last two to three decades, but there is much more that can be done. Particularly important is to understand how environment and lifestyle influence the disease. This may be part of the key to prevention, as well as more cost-effective treatment. Metabolomics is a powerful tool to enable this,” explained Matthews.
A double blind phase III trial is currently recruiting to further test this theory in multiple locations throughout Ireland and the United Kingdom.
It will have 1,180 participants taking simvastatin for three years.