Obesity, MS and the vascular system
February 1, 2013 at 8:13am
A new study in the news regarding an elevated MS risk in obese children, particularly girls. Here is the abstract.
The study found that the risk of developing MS was more than one and a half times higher for overweight girls than girls who were not overweight, nearly 1.8 times higher in moderately obese girls compared to girls of normal weight and nearly four times higher in extremely obese girls.
Dr. Langer-Gould's new study finds a correlation between obesity and MS risk in girls, more so than in boys.
No clear cause-and-effect has been established, but there are some theories that link the two conditions. "Estrogen in fat produces pro-inflammatory [substances], and obesity is known to be a low-grade inflammatory state," she said. "After going through puberty, girls have higher estrogen levels than boys, so overweight girls are getting a double whammy.
This may well be true regarding estrogen---but then, why do other studies show a protective effect of estrogen on women with MS?
What if it is not simply about the hormones, but also about how obesity affects the endothelium, veins and cerebral perfusion?
Obesity changes venous health
Obesity also makes you more likely to develop chronic vein disease, a condition in which the veins become unable to pump enough blood back to the heart, causing blood to pool in the legs. This type of vein disease is common in obese women, who have more blood to move through the body and often have reduced physical activity.17 Overweight and obese patients are also at increased risk for problems caused by vein disease, like skin changes and ulcers on the legs. In one study of 272 patients (64% were women) with chronic vein disease, the more excess weight a person carried, the more severe their disease.18
Obesity changes cerebral perfusion
The current findings suggest that cerebral hypoperfusion and obesity interact to impair cognitive performance in persons with HF.
Obesity creates hypercoagulation and damages the endothelium in children
In our study, we found that there is a procoagulant increase in the coagulation system activity of obese children compared to non-obese healthy children, whereas there is a significant decrease in anticoagulant system. These changes occurred in obese patients, especially higher levels of plasma procoagulant factors such as fibrinogen, FVIII, FIX, and von Willebrand factor, lead us to think that there is an activity in these patients at endothelial level. Further studies are needed on endothelial activity of obese children.
Obviously, not every overweight girl develops MS, and not everyone with MS is overweight. But let's not miss the larger point. Here is yet another connection between MS and the vasculature.
Please share and discuss in your MS community and with your doctors.
Be well,
Joan
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