Factors Influencing the Degree of Disability in Patients With Multiple Sclerosis

Abstract

Objective: To explore the factors influencing the degree of disability in patients with multiple sclerosis (MS), and to provide evidence for its early diagnosis, prognostic evaluation and clinical intervention.Methods: This retrospective observational study included 72 patients with relapsing-remitting multiple sclerosis (RRMS) at the First Hospital of Shanxi Medical University. All patients completed craniocerebral and spinal cord MRI (with or without Gd enhancement) and were evaluated for Expanded Disability Status Score (EDSS) scores before receiving treatment.Results: Among 72 patients with RRMS, 45 (62.5%) had an EDSS score ≤3; A total of 27 patients (37.5%) had an EDSS score >3 points. Univariate analysis showed that age, annual recurrence rate (ARR), drug use, albumin (ALB), triglycerides (TG), and total number of lesions in groups with EDSS score ≤3 were significantly different from those with an EDSS score > 3 points (P < 0.05). Multivariate logistic regression analysis showed that ALB, total number of lesions, and drug use were independent influencing factors of the degree of disability in patients with MS, and the difference was statistically significant (P < 0.05). An ROC curve was constructed using ALB and the total number of lesions. The AUC of ALB was 0.681, P < 0.05, and the best cut-off value was 44.2 g/L. Its sensitivity to predict the degree of disability in patients with multiple sclerosis was 85.2%, while its specificity was 51.1%. The AUC of the total number of lesions was 0.665 (P < 0.05) and the best cut-off value was 5.5. Its sensitivity to predict the degree of disability in patients with multiple sclerosis was 70.4%, while its specificity was 64.4%. The AUC of the combined ALB, total number of lesions, and drug use was 0.795 (P < 0.05), sensitivity was 77.8, and specificity was 73.3%. The optimal diagnostic cut-off value of the regression equation for the EDSS score of patients with multiple sclerosis was 0.420.Conclusion: Serum ALB, total number of lesions, and drug use in patients with multiple sclerosis were independent factors influencing the degree of disability. These findings provide clinical evidence for the prognostic evaluation and early intervention of patients with multiple sclerosis.

Oxidative Stress and the Nuclear Factor Erythroid 2-Related Factor 2 (Nrf2) Pathway in Multiple Sclerosis: Focus on Certain Exogenous and Endogenous Nrf2 Activators and Therapeutic Plasma Exchange Modulation

“…Consistent with this, a recent meta-analysis identified hypoalbuminemia in MS as strong clinical evidence of increased OS [173]. However, there are controversial data on cohorts without hypoalbuminemia in MS patients as well [174,175]. So far, there is only one study that longitudinally analyzed the effect of plasmapheresis or immunoabsorption (IA) on albumin quantity and redox state in patients with autoimmune-mediated neurological disorders [176].…”

Factors influencing the degree of disability in patients with neuromyelitis optica spectrum disorders

“…In addition to the functions discussed above, albumin has a direct neuroprotective effect on neurons and glial cells, with studies showing that ALB is beneficial to astrocytes, microglia, and nerve cells [ 35 ]. It has also been reported that serum ALB level is an important factor affecting the degree of disability in patients with multiple sclerosis [ 36 ]. In addition, ALB has been found to be a predictor of the diagnosis of multiple sclerosis and in distinguishing progressive multiple sclerosis [ 37 ].…”

Severe and long-lasting alteration of albumin redox state by plasmapheresis

“…It was observed earlier, that patients with autoimmune mediated neurological conditions, in particular multiple sclerosis, sometimes experience hypoalbuminemia 26 . However, cohorts without hypoalbumemia have also been reported and the role of albumin in multiple sclerosis is controversially discussed in the literature 14 , 27 . No instances of hypoalbuminemia were observed in our study and all included patients exhibited serum albumin levels within the normal range before the first apheresis treatment.…”