Impact of Adiposity, Insulin Resistance, and Lipid Profile on Clinical Characteristics in Patients with Relapsing– Remitting Multiple Sclerosis

Objective Metabolic disturbances have increasingly been recognized as potential modifiers of disease course in multiple sclerosis (MS). This study aimed to evaluate insulin resistance, anthropometric parameters, and lipid profiles in patients with relapsing–remitting MS (RRMS) and to investigate their association with clinical disability. Methods This single‑center prospective case–control study included 70 RRMS patients diagnosed according to the 2017 revised McDonald criteria and 70 age‑matched healthy controls. Demographic characteristics, anthropometric measurements (body mass index and waist circumference), biochemical markers related to insulin resistance, and lipid profile parameters were recorded. Insulin resistance was assessed using the homeostatic model assessment (HOMA‑IR). Multivariate regression analyses were performed to explore independent predictors of insulin resistance and disability measured with the Expanded Disability Status Scale (EDSS). Results Compared with healthy controls, patients with RRMS had significantly higher body weight, body mass index, and waist circumference. Total cholesterol and HDL‑cholesterol levels were also significantly higher in the MS group. However, fasting glucose, fasting insulin, and HOMA‑IR values were comparable between groups. Multivariate regression analysis demonstrated that waist circumference was independently associated with HOMA‑IR values. Among MS patients, those with insulin resistance showed significantly higher triglyceride levels. Patients with abdominal obesity and elevated BMI demonstrated significantly higher total cholesterol and LDL‑cholesterol levels. No independent association was observed between lipid profile parameters or insulin resistance and EDSS scores. Triglyceride levels were significantly lower in patients receiving dimethyl fumarate therapy compared with those treated with fingolimod or ocrelizumab. Conclusion RRMS patients exhibit increased adiposity and alterations in lipid metabolism compared with healthy individuals. These metabolic changes appear to be primarily associated with adiposity rather than insulin resistance. Although lipid abnormalities were not independently associated with disability in this cohort, metabolic alterations may still represent important comorbid factors in MS and warrant further investigation in larger longitudinal studies.