Impact of body mass index on clinical presentation and prognosis in myasthenia gravis

Abstract Background The literature lacks consistent information on the correlation between baseline body mass index (BMI), clinical presentation, and prognosis in patients with myasthenia gravis (MG). This observational multicenter prospective cohort study included patients with MG from February 201...

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Main Authors: Hong-xi Chen, Zi-ya Wang, Na-na Zhang, Xue Lin, Zi-yan Shi, Xiao-fei Wang, Ying Zhang, Qin Du, Ling-yao Kong, Dong-ren Sun, Rui Wang, Yang-yang Zhang, Shuang-jie Li, Yu-wei Da, Hui-yu Feng, Hong-yu Zhou
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03902-1
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author Hong-xi Chen
Zi-ya Wang
Na-na Zhang
Xue Lin
Zi-yan Shi
Xiao-fei Wang
Ying Zhang
Qin Du
Ling-yao Kong
Dong-ren Sun
Rui Wang
Yang-yang Zhang
Shuang-jie Li
Yu-wei Da
Hui-yu Feng
Hong-yu Zhou
author_facet Hong-xi Chen
Zi-ya Wang
Na-na Zhang
Xue Lin
Zi-yan Shi
Xiao-fei Wang
Ying Zhang
Qin Du
Ling-yao Kong
Dong-ren Sun
Rui Wang
Yang-yang Zhang
Shuang-jie Li
Yu-wei Da
Hui-yu Feng
Hong-yu Zhou
author_sort Hong-xi Chen
collection DOAJ
description Abstract Background The literature lacks consistent information on the correlation between baseline body mass index (BMI), clinical presentation, and prognosis in patients with myasthenia gravis (MG). This observational multicenter prospective cohort study included patients with MG from February 2017 to June 2023, categorizing them by baseline BMI. The primary outcome was the time to generalization of ocular MG. Secondary outcomes included the time to Activities of Daily Living (ADL) response and Minimal Symptom Expression (MSE). Kaplan-Meier curves and multivariable Cox proportional hazards regression models were used to assess the impact of BMI on these outcomes. Results Out of 940 MG patients (510 women) included, 524 had a low BMI and 416 had a high BMI, with a median age of 50.00 years. Patients in the high BMI group were significantly older (p < 0.001), had a lower percentage of females (p < 0.001), and had a shorter disease duration (p = 0.014) compared to those with a low BMI. They also had higher rates of ocular onset (p < 0.001), ocular MG classification (p = 0.001), and acetylcholine receptor antibody seropositivity (p = 0.007), but a lower incidence of thymectomy (p = 0.027). During a median follow-up of 33.00 months, the adjusted Cox models revealed that a higher baseline BMI was associated with an increased risk of ocular MG generalization (HR 1.06; 95% CI 1.01–1.11; p = 0.026), but not with ADL response (HR 0.99; 95% CI 0.95–1.04; p = 0.779) or MSE (HR 0.97; 95% CI 0.92–1.02; p = 0.240). Conclusions A higher baseline BMI was associated with an increased risk of ocular MG generalization but not with ADL response or MSE.
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spelling doaj-art-9fecbb9c519e472b94b04c9dfdb39cc52025-08-20T03:42:07ZengBMCOrphanet Journal of Rare Diseases1750-11722025-07-012011710.1186/s13023-025-03902-1Impact of body mass index on clinical presentation and prognosis in myasthenia gravisHong-xi Chen0Zi-ya Wang1Na-na Zhang2Xue Lin3Zi-yan Shi4Xiao-fei Wang5Ying Zhang6Qin Du7Ling-yao Kong8Dong-ren Sun9Rui Wang10Yang-yang Zhang11Shuang-jie Li12Yu-wei Da13Hui-yu Feng14Hong-yu Zhou15Department of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityDepartment of Neurology, Xuanwu Hospital, Capital Medical UniversityDepartment of Neurology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Neurology, West China Hospital, Sichuan UniversityAbstract Background The literature lacks consistent information on the correlation between baseline body mass index (BMI), clinical presentation, and prognosis in patients with myasthenia gravis (MG). This observational multicenter prospective cohort study included patients with MG from February 2017 to June 2023, categorizing them by baseline BMI. The primary outcome was the time to generalization of ocular MG. Secondary outcomes included the time to Activities of Daily Living (ADL) response and Minimal Symptom Expression (MSE). Kaplan-Meier curves and multivariable Cox proportional hazards regression models were used to assess the impact of BMI on these outcomes. Results Out of 940 MG patients (510 women) included, 524 had a low BMI and 416 had a high BMI, with a median age of 50.00 years. Patients in the high BMI group were significantly older (p < 0.001), had a lower percentage of females (p < 0.001), and had a shorter disease duration (p = 0.014) compared to those with a low BMI. They also had higher rates of ocular onset (p < 0.001), ocular MG classification (p = 0.001), and acetylcholine receptor antibody seropositivity (p = 0.007), but a lower incidence of thymectomy (p = 0.027). During a median follow-up of 33.00 months, the adjusted Cox models revealed that a higher baseline BMI was associated with an increased risk of ocular MG generalization (HR 1.06; 95% CI 1.01–1.11; p = 0.026), but not with ADL response (HR 0.99; 95% CI 0.95–1.04; p = 0.779) or MSE (HR 0.97; 95% CI 0.92–1.02; p = 0.240). Conclusions A higher baseline BMI was associated with an increased risk of ocular MG generalization but not with ADL response or MSE.https://doi.org/10.1186/s13023-025-03902-1Body mass indexMyasthenia GravisGeneralization of ocular myasthenia GravisActivities of daily living responseMinimal symptom expression
spellingShingle Hong-xi Chen
Zi-ya Wang
Na-na Zhang
Xue Lin
Zi-yan Shi
Xiao-fei Wang
Ying Zhang
Qin Du
Ling-yao Kong
Dong-ren Sun
Rui Wang
Yang-yang Zhang
Shuang-jie Li
Yu-wei Da
Hui-yu Feng
Hong-yu Zhou
Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
Orphanet Journal of Rare Diseases
Body mass index
Myasthenia Gravis
Generalization of ocular myasthenia Gravis
Activities of daily living response
Minimal symptom expression
title Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
title_full Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
title_fullStr Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
title_full_unstemmed Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
title_short Impact of body mass index on clinical presentation and prognosis in myasthenia gravis
title_sort impact of body mass index on clinical presentation and prognosis in myasthenia gravis
topic Body mass index
Myasthenia Gravis
Generalization of ocular myasthenia Gravis
Activities of daily living response
Minimal symptom expression
url https://doi.org/10.1186/s13023-025-03902-1
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