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Key Biomarker in MS Associated With Diabetes in Study


Data on the link between elevated serum neurofilament light chain and diabetes was presented at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, held in Stockholm, Sweden.

A researcher from Johns Hopkins School of Medicine presented data at a recent international meeting on multiple sclerosis (MS) that show elevated levels of serum neurofilament light chain (sNfL), an emerging biomarker in MS, is associated with a 2-fold risk diabetes.

Kathryn Fitzgerald, ScD, associate professor of neurology at Johns Hopkins, presented the findings September 11 at the 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in Stockholm, Sweden. Fitzgerald presented results of an evaluation of demographic and comorbid characteristics seen in sNfL samples from a large, heterogeneous population of patients in the MS Partners Advancing Technology and Health Solutions (MS PATHS) program. The MS PATHS network includes 10 centers across the United States and Europe that collaborate through standardized collection of data and biosamples during clinic visits.

Fitzgerald noted that sNfL is becoming a potentially important biomarker in a number of neurological conditions. In MS, she said, “sNfL correlates with disease severity and is emerging as a promising biomarker that could be used for disease monitoring and risk stratification.”

Previously, however, evaluation of the biomarker took place in clinical trials in which the patient populations lacked diversity and comorbidities. The MS PATHS study sought to fill in these knowledge gaps, she said.

In the study, sNfL levels were measured in 1969 patients with MS as well as 130 healthy controls through the Single Molecule Array, or SIMOA Assay, from Quanterix. Researchers determined cut points based on age from the healthy controls and used those to determine levels of normal or elevated sNfL.

From there, they evaluated this biomarker relative to number of key physical performance markers: walking speed, manual dexterity, and processing speed, with adjustments for age, sex, disease subtype, disease duration, and the patient’s therapy. Then, researchers evaluated whether there were any differences in sNfL by race or comorbidity.

Notably, Fitzgerald said, there were no differences in sNfL by race or sex. Unsurprisingly, patients with elevated sNfL had 10% slower walking speed and 7% slower manual dexterity speed. Processing speed scores were lower, with a mean difference of —3.78 (95% CI, –4.84 to –2.70; P <.001).

People with diabetes were more likely to have elevated sNfL, with an overall risk of 2.24 (95% CI, 1.41-3.58; P = .0007). However, sNfL levels did not differ in patients with hyperlipidemia, hypertension, or renal insufficiency, and researchers reported that the link with obesity “was complex and may vary by disability.”

During the ECTRIMS session on biomarkers, Fitzgerald was asked if there was a difference in association between elevated sNfL and type 1 or type 2 diabetes. The study did not differentiate between the types, she said, but most cases were type 2.

Biogen funded the study.


Fitzgerald K, Sotirchos E, Smith M, et al. Serum neurofilament light chain is associated with MS outcomes and comorbidity in a large population of people with multiple sclerosis. Presented at: 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis; September 11-13, 2019; Stockholm, Sweden. Abstract 23. https://onlinelibrary.ectrims-congress.eu/ectrims/2019/stockholm/279375.

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