Multiple sclerosis and sarcopenia: analysis of population-level prevalence and key risk factors from the UK Biobank

Sarcopenia and presarcopenia are characterized by the age-related deterioration of skeletal muscle mass and/or function and are associated with adverse health outcomes. The relationship between multiple sclerosis (MS) and sarcopenia/presarcopenia are poorly understood.

To examine the prevalence of presarcopenia/sarcopenia in people with MS compared to the non-MS population.

Data from over 500,000 participants were sourced from the UK Biobank. The primary outcome was sarcopenia or presarcopenia status, based on low grip strength or low skeletal muscle index per the revised European Working Group on Sarcopenia in Older People (EWGSOP2) definition. Individuals with MS were compared to the general population.

Individuals with MS (n = 1798) compared to the general population have a multiple-fold higher prevalence of sarcopenia (1.1 vs 0.3 %; OR 3.69, CI 2.26-5.65) and presarcopenia (14.1 vs 7.2 %; OR 2.11, CI 1.84-2.41). Advanced age (>65 years in comparison to 45-50 years, OR = 4.57, CI 4.32-4.83) and low BMI (OR = 7.34, CI 6.62-8.13) were associated with increased presarcopenia prevalence. Male sex (OR = 0.40, CI 0.39-0.41) was associated with decreased presarcopenia prevalence. In older age groups, presarcopenia in MS may be more related to weakness than low muscle mass.

People with MS are at significantly greater risk of developing presarcopenia or sarcopenia and are more likely to develop presarcopenia earlier in life compared to the general population. Low BMI and female sex were positively associated with development of presarcopenia in MS.