Lipid alterations and endothelial dysfunction are associated with multiple sclerosis pathophysiology

Multiple sclerosis (MS) is classically considered a central nervous system (CNS)-restricted immune-mediated disorder; however, increasing evidence suggests that systemic mechanisms may contribute to its pathophysiology. This study examined the relationship between lipid profile alterations and endothelial dysfunction in individuals with MS and their associations with disease severity. Intima-media thickness (IMT) and circulating markers of endothelial activation (E-selectin and P-selectin) were assessed in patients with MS and healthy controls. Serum lipid parameters, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL cholesterol, and triglycerides (TG), were measured. Associations between vascular markers, lipid parameters, and clinical characteristics, including Expanded Disability Status Scale (EDSS) scores and disease duration, were analysed. Compared with controls, MS patients demonstrated significant alterations in lipid profiles that correlated with endothelial dysfunction markers and IMT. Soluble E-selectin, TC, HDL-C, and LDL-C showed discriminatory potential between MS patients and healthy individuals. Notably, IMT values were significantly lower in the MS group than in controls, despite higher body-mass index (BMI) and altered lipid profile, suggesting non-atherosclerotic vascular remodelling. Significant associations were also observed between lipid and endothelial markers and clinical measures, including EDSS scores and disease duration. These findings indicate that MS is accompanied by systemic vascular and lipid alterations that extend beyond the CNS.