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Demographics and clinical records were reviewed. Anderson\u2013Gill, Kaplan\u2013Meier, and Cox models evaluated the body mass index's effect on relapse risk and long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 246 patients with 799 neuromyelitis optica spectrum disorder attacks study, 36 patients had low, 133 had normal, 77 had high body mass index, with a mean onset age of 40\u2009\u00b1\u200913\u2009years, and the population was 88% female. The medium follow\u2010up time was 49\u2009months; AQP4\u2010IgG was found in 193 (78%) patients. Onset and relapse of area postrema syndrome were less frequent in patients with a normal body mass index. The annual relapse rate after immunosuppressive therapy was significantly lower in patients with a low body mass index. In the multivariable analysis, statistical correlation still existed between body mass index at onset and risk of relapse (HR\u2009=\u20091.03, 95% CI: 1.03\u20131.03, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), risk of severe attack (HR\u2009=\u20090.92, 95% CI: 0.86\u20130.98, <jats:italic>P<\/jats:italic>\u2009=\u20090.013), risk of visual disability (HR\u2009=\u20090.9, 95% CI: 0.81\u20131, <jats:italic>P<\/jats:italic>\u2009=\u20090.047), and overall risk of disability (HR\u2009=\u20090.89, 95% CI: 0.82\u20130.98, <jats:italic>P<\/jats:italic>\u2009=\u20090.015) after adjusting various variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Lower body mass index at onset was associated with less frequent relapse but poor prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51857","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T04:46:22Z","timestamp":1690433182000},"page":"1673-1681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Initial BMI effects on clinical presentation and prognosis in neuromyelitis optica spectrum disorder"],"prefix":"10.1002","volume":"10","author":[{"given":"Wenqin","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Neurology West China Hospital, Sichuan University No. 37 Guo Xue Xiang Chengdu 610041 Sichuan Province PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology West China Hospital, Sichuan University No. 37 Guo Xue Xiang Chengdu 610041 Sichuan Province PR 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