Multiple Sclerosis Resource Centre

Welcome to the Multiple Sclerosis Resource Centre. This website is intended for international healthcare professionals with an interest in Multiple Sclerosis. By clicking the link below you are declaring and confirming that you are a healthcare professional

You are here

Cholesterol and markers of cholesterol turnover in multiple sclerosis: relationship with disease outcomes

Multiple Sclerosis and Related Disorders, Volume 5, January 2016, Pages 53–65


Multiple sclerosis (MS) is a chronic central nervous system disease that is associated with progressive loss of myelin and subsequent axonal degeneration. Cholesterol is an essential component of mammalian cellular and myelin membranes. In this systematic review, we examined the relationship between levels of cholesterol and markers of cholesterol turnover in circulation and/or cerebrospinal fluid (CSF) and disease outcomes in adults with clinically isolated syndrome (CIS) or confirmed MS. Studies suggest that elevated levels of circulating low density lipoprotein cholesterol (LDL), total cholesterol, and particularly, apolipoprotein B and oxidized LDL are associated with adverse clinical and MRI outcomes in MS. These relationships were observed as early as CIS. The studies also suggest that oxysterols, cholesterol precursors, and apolipoprotein E may be markers of specific disease processes in MS, but more research is required to elucidate these processes and relationships. Taken together, the data indicate that cholesterol and markers of cholesterol turnover have potential to be used clinically as biomarkers of disease activity and may even be implicated in the pathogenesis of MS.


  • We examine 21 studies of cholesterol and cholesterol metabolites in MS progression.
  • Elevated total cholesterol, LDL, ox-LDL, ApoB are associated with adverse outcomes.
  • Further work is needed to address possible associations between ApoE or ApoD and MS outcome.

Keywords: Cholesterol, Biomarker, Multiple sclerosis, Clinically isolated syndrome, Apolipoprotein, ApoA, ApoB, ApoD, ApoE, Lipoprotein, LDL, HDL, Oxysterol, 24-hydroxycholesterol.


a Department of Clinical Neurosciences, University of Calgary, Calgary, Canada

b Hotchkiss Brain Institute, University of Calgary, Calgary, Canada

c Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada

d Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands

e Department of Neuroscience, Centre de recherche du CHU de Québec – Université Laval, Québec, Canada

f Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec, Canada

Correspondence to: Centre de recherche du CHU de Québec – Université Laval, Pavillon CHUL, 2705 boul Laurier, Québec, Canada G1V 4G2.