Metabolic comorbidity is overrepresented in people with multiple sclerosis (MS) and is associated with adverse MS outcomes. Excess visceral adiposity, approximated using waist circumference (WC), is a risk factor for metabolic comorbidity and predicts poorer outcomes in other neurologic diseases.

A team of researchers, including Dr. Gary Cutter, professor of biostatistics at the University of Alabama at Birmingham School of Public Health, set out to evaluate the association between WC and clinical and disease characteristics in people with MS.

North American Research Committee on MS (NARCOMS) registry participants reported height and weight (used to calculate body mass index (BMI)) and were mailed a tape measure with instructions to measure WC. The team considered WC continuously and used cut-points derived from the abdominal obesity criteria for the metabolic syndrome (men: WC ⩾ 40 in; women: WC ⩾ 35 in). The team assessed the association between WC and disability (Patient-Determined Disease Steps) and symptom severity (validated scales) using multivariable-adjusted multinomial models.

Of 6367 responders with MS, the team included 5832 (92 percent). Of these, 3181 (55 percent) reported WC meeting criteria for the abdominal obesity component of metabolic syndrome. In multivariable models adjusting for overall obesity status, WC was associated with 47 percent increased odds of severe versus mild disability (odds ratio (OR): 1.47; 95 percent confidence interval (CI): 1.22-1.78).

Increased WC is associated with more severe disability, even after adjusting for overall obesity in this large cross-sectional survey.

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