![]() ![]() MOGAD-ON can sometimes be mistaken for pseudotumor cerebri because patients can present with severe headaches and bilateral optic disc edema 8– 10. Prior studies have suggested that obesity may play a predisposing risk factor for MS 5– 7, but this has not been explored in aquaporin 4-IgG positive NMOSD (AQP4-IgG+ NMOSD) or MOGAD. The pathophysiology of these diseases is still being elucidated, especially for MOGAD because it is the most recently described entity 3, 4. Optic neuritis (ON) is one of the most common clinical presentations at disease onset of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), neuromyelitis optica spectrum disorder (NMOSD), and multiple sclerosis (MS) 1, 2. Our findings require further exploration, but could have significant pathophysiologic implications if confirmed in larger prospective studies. This study suggests an association between obesity and MOGAD. Mixed-effects multinomial logistic regression, adjusted for age and sex, with obesity as a binary variable, revealed that obesity was associated with a higher odds ratio (OR) of a subsequent MOGAD diagnosis (OR 5.466, 95% CI, p = 0.001) in contradistinction with AQP4-IgG+ NMOSD. A higher BMI was significantly associated with a diagnosis of MOGAD-ON ( p < 0.001) in MOGAD patients the mean BMI was 31.6 kg/m 2 (standard deviation (SD) 7.2), while the mean BMI was 24.7 kg/m 2 (SD 5.3) in AQP4-IgG+ NMOSD patients, and 26.9 kg/m 2 (SD 6.2) in MS patients. Main outcome measures included BMI in patients with acute ON and subsequent diagnosis of MOGAD, AQP4-IgG+ NMOSD or MS. A mixed model analysis was performed to assess the potential of obesity or BMI to predict MOGAD-ON, and to distinguish MOGAD-ON from AQP4-IgG+ NMOSD-ON and MS-ON. The following data was collected: age, sex, ethnicity, BMI (documented before corticosteroid treatment), and the ON etiology after diagnostic work-up. In this multicenter non-interventional retrospective study, data was collected from patients with a first ever demyelinating attack of ON subsequently diagnosed with MOGAD (n = 44), AQP4-IgG+ NMOSD (n = 49) or MS (n = 90) between 20. We aimed to investigate a possible association between obesity (body mass index > 30 kg/m 2) in patients with MOGAD, aquaporin 4-IgG positive NMOSD (AQP4-IgG+ NMOSD) or MS. While obesity has been reported to potentially be a risk factor for MS, this has not been explored in NMOSD or MOGAD. The pathophysiology underlying these diseases, especially MOGAD, is still being elucidated. Optic neuritis (ON) is a frequent presentation at onset of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). ![]()
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