Browne RW, et al. - In this cross-sectional analysis, researchers evaluated relapsing-remitting multiple sclerosis (MS) patients (n=75, mean age ± SD: 49.6 ± 11 years, 69% female, median Expanded Disability Status Scale score: 2.0) to determine if cholesterol biomarkers and serum neurofilament light chain impact fatigue. They used Fatigue Severity Scale (FSS), Expanded Disability Status Scale, and the Beck Depression Index–Fast Screen, to evaluate fatigue, disability, and depression, respectively. An association between lower FSS and severe fatigue status with greater high-density lipoprotein cholesterol (HDL-C) and lower total cholesterol (TC) to HDL-C ratio was revealed in regression analyses adjusted for age, sex, disability, and depression. A link between apolipoprotein A-II and FSS was also observed. Overall, an association between TC to HDL-C ratio and MS fatigue was evident in this study. In MS fatigue, a potential role for the HDL-C pathway was suggested.