J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 18, Number 9, September 2026, pages 679-686

Nutritional Status in Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder, and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease

↓ Figure 1. The nutritional status of patients is categorized by the MNA score. (a) Bar graph of the mean MNA score between each group. (b) Bar graph of the proportions of nutritional status of healthy controls, MS, NMOSD, and MOGAD patients. MNA: Mini Nutritional Assessment; MOGAD: myelin oligodendrocyte glycoprotein antibody-associated disease; MS: multiple sclerosis; NMOSD: neuromyelitis optica spectrum disorder.

↓ Figure 2. Correlation between clinical disability and nutritional status. The scatter plot demonstrates the relationship between EDSS scores and MNA scores across the demyelinating disease cohorts. EDSS: Expanded Disability Status Scale; MNA: Mini Nutritional Assessment.

↓ **Table 1.** Demographic Data and Baseline Characteristics Among Patients With Central Nervous System Demyelinating Diseases
Characteristics	Healthy controls (n = 100)	Total (n = 222)	MS (n = 100)	NMOSD (n = 105)	MOGAD (n = 17)	P-value
ARR: annualized relapsed rate; BMI: body mass index; EDSS: Expanded Disability Status Scale; IQR: interquartile range; MOGAD: myelin oligodendrocyte glycoprotein antibody-associated disease; MS: multiple sclerosis; NA: not available; NMOSD: neuromyelitis optica spectrum disorder; SD: standard deviation.
Age at recruitment (years), mean ± SD	46.3 ± 3.3	46.2 ± 15.2	40.0 ± 12.8	52.5 ± 14.3	43.9 ± 18.2	< 0.001
Age of onset (years), mean ± SD	NA	35.7 ± 14.9	30.3 ± 11.8	40.7 ± 15.8	36.6 ± 14.9	< 0.001
Female sex, n (%)	85 (85.0)	188 (84.7)	76 (76.0)	101 (96.2)	11 (64.7)	< 0.001
BMI (kg/m²), mean ± SD	24.1 ± 4.9	23.5 ± 5.0	23.4 ± 5.0	23.4 ± 4.9	25.0 ± 6.1	0.448
Weight (kg), mean ± SD	62.4 ± 5.4	60.7 ± 14.2	62.2 ± 13.8	58.4 ± 13.0	65.6 ± 6.1	0.053
Number of attacks, median (IQR)	NA	3.0 (1.0–5.0)	2.0 (1.0–3.5)	3.0 (1.0–6.0)	3.0 (1.0–5.0)	0.039
ARR, median (IQR)	NA	0.4 (0.2–0.7)	0.4 (0.2–0.7)	0.4 (0.2–0.63)	0.6 (0.3–1.0)	0.164
Disease duration (years), median (IQR)	NA	8.5 (3.9–14.5)	6.7 (3.2–13.7)	10.9 (5.0–15.3)	5.7 (1.5–9.6)	0.017
Duration from last attacks (years), median (IQR)	NA	3.7 (1.7–7.9)	3.5 (1.8–7.9)	4.2 (1.9–8.2)	2.3 (1.7–6.3)	0.647
EDSS, median (IQR)	NA	2.0 (1.0–4.0)	1.0 (0.0–3.0)	3.0 (1.0–5.5)	1.0 (1.0–2.0)	0.01
No treatment, n (%)	NA	19 (8.6)	13 (13.0)	3 (2.9)	3 (17.6)	0.001
Prednisolone, n (%)	NA	0 (0.0)	0 (0.0)	0 (0.0)	2 (11.8)	0.006
Azathioprine, n (%)	NA	75 (33.8)	20 (20)	45 (42.9)	10 (58.8)	< 0.001
Mycophenolate mofetil, n (%)	NA	25 (11.3)	8 (8.0)	15 (14.3)	2 (11.8)	0.362
Rituximab, n (%)	NA	82 (36.9)	42 (42.0)	40 (38.1)	0 (0.0)	0.004
Fingolimod, n (%)	NA	9 (4.1)	9 (9.0)	0 (0.0)	0 (0.0)	0.003
Glatiramer acetate, n (%)	NA	1 (0.5)	1 (1.0)	0 (0.0)	0 (0.0)	0.542
Natalizumab, n (%)	NA	1 (0.5)	1 (1.0)	0 (0.0)	0 (0.0)	0.542
Satralizumab, n (%)	NA	2 (0.9)	0 (0.0)	2 (1.9)	0 (0.0)	0.325
Teriflunomide, n (%)	NA	4 (1.8)	4 (4.0)	0 (0.0)	0 (0.0)	0.083
Dimethyl fumarate, n (%)	NA	2 (0.9)	2 (2.0)	0 (0.0)	0 (0.0)	0.292

↓ Table 1. Demographic Data and Baseline Characteristics Among Patients With Central Nervous System Demyelinating Diseases

Characteristics

Healthy controls (n = 100)

Total (n = 222)

MS (n = 100)

NMOSD (n = 105)

MOGAD (n = 17)

P-value

ARR: annualized relapsed rate; BMI: body mass index; EDSS: Expanded Disability Status Scale; IQR: interquartile range; MOGAD: myelin oligodendrocyte glycoprotein antibody-associated disease; MS: multiple sclerosis; NA: not available; NMOSD: neuromyelitis optica spectrum disorder; SD: standard deviation.

Age at recruitment (years), mean ± SD

46.3 ± 3.3

46.2 ± 15.2

40.0 ± 12.8

52.5 ± 14.3

43.9 ± 18.2

< 0.001

Age of onset (years), mean ± SD

35.7 ± 14.9

30.3 ± 11.8

40.7 ± 15.8

36.6 ± 14.9

< 0.001

Female sex, n (%)

85 (85.0)

188 (84.7)

76 (76.0)

101 (96.2)

11 (64.7)

< 0.001

BMI (kg/m²), mean ± SD

24.1 ± 4.9

23.5 ± 5.0

23.4 ± 5.0

23.4 ± 4.9

25.0 ± 6.1

0.448

Weight (kg), mean ± SD

62.4 ± 5.4

60.7 ± 14.2

62.2 ± 13.8

58.4 ± 13.0

65.6 ± 6.1

0.053

Number of attacks, median (IQR)

3.0 (1.0–5.0)

2.0 (1.0–3.5)

3.0 (1.0–6.0)

3.0 (1.0–5.0)

0.039

ARR, median (IQR)

0.4 (0.2–0.7)

0.4 (0.2–0.63)

0.6 (0.3–1.0)

0.164

Disease duration (years), median (IQR)

8.5 (3.9–14.5)

6.7 (3.2–13.7)

10.9 (5.0–15.3)

5.7 (1.5–9.6)

0.017

Duration from last attacks (years), median (IQR)

3.7 (1.7–7.9)

3.5 (1.8–7.9)

4.2 (1.9–8.2)

2.3 (1.7–6.3)

0.647

EDSS, median (IQR)

2.0 (1.0–4.0)

1.0 (0.0–3.0)

3.0 (1.0–5.5)

1.0 (1.0–2.0)

0.01

No treatment, n (%)

19 (8.6)

13 (13.0)

3 (2.9)

3 (17.6)

0.001

Prednisolone, n (%)

0 (0.0)

2 (11.8)

0.006

Azathioprine, n (%)

75 (33.8)

20 (20)

45 (42.9)

10 (58.8)

< 0.001

Mycophenolate mofetil, n (%)

25 (11.3)

8 (8.0)

15 (14.3)

2 (11.8)

0.362

Rituximab, n (%)

82 (36.9)

42 (42.0)

40 (38.1)

0 (0.0)

0.004

Fingolimod, n (%)

9 (4.1)

9 (9.0)

0 (0.0)

0.003

Glatiramer acetate, n (%)

1 (0.5)

1 (1.0)

0 (0.0)

0.542

Natalizumab, n (%)

1 (0.5)

1 (1.0)

0 (0.0)

0.542

Satralizumab, n (%)

2 (0.9)

0 (0.0)

2 (1.9)

0 (0.0)

0.325

Teriflunomide, n (%)

4 (1.8)

4 (4.0)

0 (0.0)

0.083

Dimethyl fumarate, n (%)

2 (0.9)

2 (2.0)

0 (0.0)

0.292

↓ **Table 2.** Univariate and Multivariate Poisson Regression to Predict the Risk of Malnutrition and Patients at Risk of Malnutrition
	Univariate regression	Multivariate regression
Adjusted PRs were calculated using a stepwise multivariate model adjusting for diagnosis subtype, number of attacks, disease duration, BMI, and EDSS scores. Variables with a univariate P value < 0.10 that did not remain significant in the final model following stepwise selection are designated as not applicable (NA). BMI: body mass index; CI: confidence interval; DMT: disease-modifying therapy; EDSS: Expanded Disability Status Scale; MOGAD: myelin oligodendrocyte glycoprotein antibody-associated disease; MS: multiple sclerosis; NMOSD: neuromyelitis optica spectrum disorder; PR: prevalence ratio.
Diagnosis
MS	Ref	Ref	Ref	Ref
NMOSD	1.09 (0.80–1.48)	0.594	0.94 (0.72–1.23)	0.635
MOGAD	1.68 (1.15–2.47)	0.008	2.02 (1.49–2.93)	< 0.001
Sex
Male	Ref	Ref
Female	1.24 (0.79–1.95)	0.357
Concurrent tumors/malignancy	1.22 (0.67–2.23)	0.519
Concurrent psychiatric disorders	1.63 (1.10–2.42)	0.014	NA	NA
Preexisting cardiometabolic risk factors	1.03 (0.77–1.37)	0.859
Number of attacks	1.04 (1.01–1.05)	< 0.001	1.01 (0.99–1.02)	0.228
Age	1.01 (0.97–1.02)	0.206
Disease duration	1.02 (1.00–1.03)	0.064	1.01 (0.99–1.02)	0.377
Lower BMI (continuous)	1.11 (1.08–1.14)	< 0.001	1.09 (1.06–1.14)	< 0.001
EDSS	1.16 (1.11–1.21)	< 0.001	1.13 (1.08–1.19)	< 0.001
Treatment categories
No treatment	Ref	Ref
Low-moderate efficacy DMT	1.18 (0.66–2.11)	0.584
High efficacy DMT	1.30 (0.72–2.33)	0.385

↓ Table 2. Univariate and Multivariate Poisson Regression to Predict the Risk of Malnutrition and Patients at Risk of Malnutrition

Univariate regression

Multivariate regression

Crude PR 95%CI

P-value

Adjusted PR (95% CI)

P-value

Adjusted PRs were calculated using a stepwise multivariate model adjusting for diagnosis subtype, number of attacks, disease duration, BMI, and EDSS scores. Variables with a univariate P value < 0.10 that did not remain significant in the final model following stepwise selection are designated as not applicable (NA). BMI: body mass index; CI: confidence interval; DMT: disease-modifying therapy; EDSS: Expanded Disability Status Scale; MOGAD: myelin oligodendrocyte glycoprotein antibody-associated disease; MS: multiple sclerosis; NMOSD: neuromyelitis optica spectrum disorder; PR: prevalence ratio.

Diagnosis

Ref

NMOSD

1.09 (0.80–1.48)

0.594

0.94 (0.72–1.23)

0.635

MOGAD

1.68 (1.15–2.47)

0.008

2.02 (1.49–2.93)

< 0.001

Sex

Male

Ref

Female

1.24 (0.79–1.95)

0.357

Concurrent tumors/malignancy

1.22 (0.67–2.23)

0.519

Concurrent psychiatric disorders

1.63 (1.10–2.42)

0.014

Preexisting cardiometabolic risk factors

1.03 (0.77–1.37)

0.859

Number of attacks

1.04 (1.01–1.05)

< 0.001

1.01 (0.99–1.02)

0.228

Age

1.01 (0.97–1.02)

0.206

Disease duration

1.02 (1.00–1.03)

0.064

1.01 (0.99–1.02)

0.377

Lower BMI (continuous)

1.11 (1.08–1.14)

< 0.001

1.09 (1.06–1.14)

< 0.001

EDSS

1.16 (1.11–1.21)

< 0.001

1.13 (1.08–1.19)

< 0.001

Treatment categories

No treatment

Ref

Low-moderate efficacy DMT

1.18 (0.66–2.11)

0.584

High efficacy DMT

1.30 (0.72–2.33)

0.385