Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Li, Jin-Yue; Sun, Xiaohan; Cai, Zhengyi; Shen, Dongchao; Yang, Xunzhe; Liu, Mingsheng

doi:10.1038/s41598-022-16229-9

Cited by 15 publications

(15 citation statements)

References 45 publications

(60 reference statements)

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“…Bioelectrical impedanciometry could be used to measure body composition through the estimation of body compartments and body cellularity function and hydration through the electrical parameters. Patients in our sample had similar values of fat-free mass index (46.99 kg) to other studies with patients with ALS and higher values of fat mass index (22.09 kg); for example, compared to the Li et al study (FFM: 47.83 kg; FMI: 17.42 kg) [16]. The phase angle was 5.02 (1.25) • in men and 5.26 (1.79) • in women; these values were lower than those from the general population of individuals of eighty or more years (men: 5.3 • (IC95%: 4.5-6.0); women: 5.4 • (IC95%: 5.3-5.6)) [19].…”

Section: Discussionsupporting

confidence: 79%

“…Nevertheless, amyotrophic lateral sclerosis has some clinical issues that affect the development of malnutrition. Muscle mass parameters measured by ultrasonography (quadriceps thickness) have an inverse relationship with the percentage of weight loss, as has been demonstrated in the study by Li et al [16]. On the other hand, ultrasound muscle mass (quadriceps thickness and muscle area) parameters have an inverse relationship with resistance and a direct relationship with estimated muscle mass parameters defined by impedanciometry; this condition demonstrates a relationship of leg muscle mass with variables that estimate whole body muscle mass.…”

Section: Discussionsupporting

confidence: 55%

“…Classical anthropometry in ALS is the most common parameter to diagnose malnutrition and to monitor the nutritional treatment. A study from Li et al showed that patients with ALS had a lower value of body mass index (BMI) than controls (ALS: 23.52 (3.11) kg/m 2 ; no ALS: 24.75 (3.34) kg/m 2 ), and they had a median weight loss of 4.11% (−9.32-0.56) [16]. In our sample, BMI and weight loss were slightly higher than in this study.…”

Section: Discussionmentioning

confidence: 99%

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Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS)

López-Gómez,

Izaola-Jauregui,

Almansa-Ruiz

et al. 2024

Nutrients

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Amyotrophic lateral sclerosis (ALS) is a progressive disease with a high prevalence of malnutrition that can influence prognosis. The main objective of this study is to compare the validity of muscle ultrasonography in the diagnosis of malnutrition and the prognosis of patients with ALS. Methods: This is a prospective observational study that analyzes the nutritional status of patients at the beginning of nutritional monitoring. The morphofunctional assessment included the examination of anthropometric variables such as weight, height, body mass index (BMI), arm circumference, and calf circumference. Additionally, electrical bioimpedanciometry (BIA) was used to measure electrical parameters and estimate other relevant metrics. Muscle ultrasonography® (quadriceps rectus femoris (QRF)) assessed muscle mass parameters, including muscle area index (MARAI), anteroposterior diameter of the QRF (Y-axis) (cm), transverse diameter of the QRF (X-axis) (cm), and the sum of the quadriceps thickness (RF+VI) (cm), as well as muscle quality parameters such as echogenicity and the Y–X index. Results: A total of 37 patients diagnosed with amyotrophic lateral sclerosis (ALS) were included in this study. Of these patients, 51.4% were men. The mean age was 64.27 (12.59) years. A total of 54.1% of the patients had a bulbar onset of amyotrophic lateral sclerosis, and 45.9% had spinal onset. The percentage of subjects with malnutrition diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria was 45.9% of patients. There was a direct correlation between muscle mass parameters assessed by muscle ultrasonography (RF+VI) and active mass markers measured by bioimpedanciometry (body cellular mass index (BCMI) (r = 0.62; p < 0.01), fat-free mass index (FFMI) (r = 0.75; p < 0.01), and appendicular skeletal mass index (ASMI) (r = 0.69; p < 0.01)). There was a direct correlation between echogenicity and resistance (r = 0.44; p = 0.02), as well as between the fat-free mass index and the Y–X index (r = 0.36; p = 0.14). Additionally, there was a negative correlation between echogenicity and BCMI (r = −0.46; p < 0.01) and ASMI (r = 0.34; p = 0.06). Patients with low quadriceps thickness (male < 2.49 cm; female < 1.84 cm) showed an increased risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 7.84 (CI 95%: 1.09–56.07); p-value = 0.04), and patients with low-quality mass (Y–X index < 0.35) had a higher risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 19.83 (CI 95%: 1.77–222.46); p-value = 0.02). Conclusions: In patients with ALS, ultrasonography echogenicity was inversely related to BCMI, FFMI, and ASMI, and the Y–X index was directly related to FFMI. The lowest quartiles of quadriceps thickness and Y–X index are risk factors for hospital admission.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS)

López-Gómez,

Izaola-Jauregui,

Almansa-Ruiz

et al. 2024

Nutrients

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“…As the COVID-19 pandemic began to spread, the need to develop new methods for managing patients with ALS became more evident (35)(36)(37). Furthermore, the lockdown was reported to impact caregivers more than the patients with ALS (38). An important prognostic indicator of ALS is weight loss, primarily through muscle and adipose tissues (39).…”

Section: Discussionmentioning

confidence: 99%

Biochemical parameters as a tool to assess the nutritional status of patients with amyotrophic lateral sclerosis

Monov,

Molodozhnikova

2024

Front. Neurol.

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BackgroundThe research aimed to analyze blood biochemical parameters in patients with amyotrophic lateral sclerosis and to determine whether they can be used to assess their nutritional status.MethodsThe study included 45 patients diagnosed with amyotrophic lateral sclerosis (ALS): 28 (62.2%) were men and 17 (37.8%) were women. The mean age of the study participants was 50.69 ± 7.24 years. The control group consisted of 30 practically healthy individuals.ResultsCompared with practically healthy individuals, patients with ALS had significantly lower blood parameters, including total lymphocyte count (1.49 ± 0.11 vs. 2.86 ± 0.25, p < 0.05), total protein (60.55 ± 2.38 vs. 77.80 ± 4.41, p < 0.05), albumin (33.70 ± 2.03 vs. 46.49 ± 3.22, p < 0.05), urea (3.09 ± 0.36 vs. 5.37 ± 0.50, p < 0.05), creatinine (51.28 ± 4.42 vs. 70.91 ± 5.13, p < 0.05), and transferrin (1.84 ± 0.12 vs. 2.32 ± 0.10, p < 0.05). These parameters correspond to first-degree malnutrition. There were direct correlations between anthropometric and biochemical parameters in the ALS group. BMI correlated with the blood levels of total protein (r = 0.22, p < 0.05), albumin (r = 0.27, p < 0.05), urea (r = 0.33, p < 0.05), creatinine (r = 0.30, p < 0.05), transferrin (r = 0.18, p < 0.05), and total lymphocyte count (r = 0.20, p < 0.05). PNI correlated with the blood levels of total protein (r = 0.53, p < 0.05), albumin (r = 0.87, p < 0.05), total cholesterol (r = 0.34, p < 0.05), transferrin (r = 0.40, p < 0.05), total lymphocyte count (r = 0.79, p < 0.05), urea (r = 0, 37, p < 0.05), and creatinine (r = 0.32, p < 0.05).ConclusionThe study presents compelling evidence supporting the utilization of biochemical parameters, including total protein, albumin, urea, creatinine, transferrin, and total lymphocyte count, for potentially evaluating the nutritional status of individuals diagnosed with ALS.

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“…Nutritional status has been studied as risk and prognostic factors in ALS. Body composition [ 3 , 4 ], malnutrition at diagnosis [ 5 , 6 ], acquired malnutrition in the course of the disease [ 7 ], and macronutrients intake [ 8 ] seem to influence the survival of patients with ALS. Also, vitamins [ 9 , 10 , 11 ] and essential metals [ 12 , 13 , 14 ] have been studied as potential risk and prognostic factors in ALS.…”

Section: Introductionmentioning

confidence: 99%

Dietary Intake of Micronutrients and Disease Severity in Patients with Amyotrophic Lateral Sclerosis

Barros

Barbosa

et al. 2023

Metabolites

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Vitamins and essential metals have been studied as potential risk and prognostic factors in amyotrophic lateral sclerosis (ALS). This study aimed to evaluate the prevalence of inadequate micronutrient intake in ALS patients, comparing subgroups according to the disease severity. Data were obtained from the medical records of 69 individuals. Assessment of disease severity was determined by the revised ALS Functional Scale (ALSFRS-R), using the median as the cutoff. The prevalence of inadequate micronutrient intake was estimated using the Estimated Average Requirements (EAR) cut-point method. The prevalence of inadequate vitamin D, E, riboflavin, pyridoxine, folate, cobalamin, calcium, zinc, and magnesium intake was considered severe. Patients with lower ALSFRS-R scores had lower intakes of vitamin E (p < 0.001), niacin (p = 0.033), pantothenic acid (p = 0.037), pyridoxin (p = 0.008), folate (p = 0.009) and selenium (p = 0.001). Therefore, ALS patients should be monitored regarding dietary intake of micronutrients essential in neurological processes.

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Correlation of weight and body composition with disease progression rate in patients with amyotrophic lateral sclerosis

Cited by 15 publications

References 45 publications

Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS)

Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS)

Biochemical parameters as a tool to assess the nutritional status of patients with amyotrophic lateral sclerosis

Dietary Intake of Micronutrients and Disease Severity in Patients with Amyotrophic Lateral Sclerosis

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