Malnutrition at diagnosis in amyotrophic lateral sclerosis (als) and its influence on survival: Using glim criteria

Gómez, Juan José López; Ballesteros-Pomar, María D.; Torres-Torres, Beatriz; Maza, Begoña Pintor de la; Penacho-Lázaro, M. Ángeles; Palacio-Mures, J.M.; Abreu-Padín, Cristina; López-Guzmán, A.; Luis-Román, Daniel Antonio De

doi:10.1016/j.clnu.2020.05.014

Cited by 35 publications

(33 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latter study did however not include screening and data on reduced muscle mass, which both may have affected the results [17]. In a population of patients with amyotrophic lateral sclerosis, L opez-G omez et al [18] found a kappa agreement between SGA and GLIM of 0.3. In our opinion, these results raise some concerns regarding the use of both GLIM and PG-SGA in a clinical setting, and highlight the immediate need for a fully defined consensus on malnutrition diagnostics.…”

Section: Discussionmentioning

confidence: 98%

Agreement between the GLIM criteria and PG-SGA in a mixed patient population at a nutrition outpatient clinic

et al. 2021

View full text Add to dashboard Cite

Background & aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a step-wise process including a screening tool of choice for risk assessment of malnutrition before assessment of diagnosis and grading of malnutrition severity. The agreement between GLIM and the established malnutrition assessment method Patient Generated-Subjective Global Assessment (PG-SGA) is uncertain. Also, several aspects of GLIM remain to be clearly defined. In this study, we compared diagnosis of malnutrition with the GLIM criteria to the PG-SGA, and explored the differences between the methods. Methods: This cross-sectional study was conducted at the Nutrition Outpatient Clinic at Oslo University Hospital, Norway. Patients were included from SeptembereDecember 2019. Nutritional Risk Screening 2002 (NRS-2002) was used as the screening tool in the GLIM process before diagnosing and grading the severity of malnutrition. Results are presented with and without the initial risk screening. The diagnostic results from the GLIM process were compared to the malnutrition diagnosis using the PG-SGA. Results: In total, 144 patients, median age 58 years, participated in the study. The full GLIM process identified 36% of the patients as malnourished, while the PG-SGA identified 69% of the patients as malnourished. Comparison of GLIM and PG-SGA showed fair agreement, however the agreement was better when the NRS-2002 screening was excluded. Considering the PG-SGA a gold standard, GLIM had a sensitivity of 51% and a specificity of 98%. The introduction of new cut-off values for fat-free mass did not considerably alter the diagnosis of malnutrition within GLIM. Conclusions: The GLIM criteria showed only fair agreement with the PG-SGA, however the agreement was better when the initial NRS-2002 screening was excluded. A joint consensus on how to perform the GLIM process is needed for comparisons of future studies, and before routine use in clinical practice.

show abstract

Section: Discussionmentioning

confidence: 98%

Agreement between the GLIM criteria and PG-SGA in a mixed patient population at a nutrition outpatient clinic

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The majority of circulating leptin is produced in adipose tissue (Zhang and Chua, 2017), with leptin mRNA levels normally being directly correlated with adipocyte size, and high circulating levels of this hormone are associated with obesity (Cohen et al, 2017;Zhang and Chua, 2017). The opposite is observed in ALS patients (Lopez-Gomez et al, 2021;Ludolph et al, 2020) as ALS causes loss of body weight, reduced fat mass, and reduced circulating leptin levels. Here we report an up-regulation of leptin mRNA levels in WAT of TDP-43 A315T mice, both at onset and at the end-stage of the disease.…”

Section: Discussionmentioning

confidence: 99%

Alterations in leptin signaling in Amyotrophic Lateral Sclerosis (ALS)

Ferrer-Donato

Contreras

Frago

et al. 2021

Preprint

View full text Add to dashboard Cite

Leptin has been suggested to play a role in amyotrophic lateral sclerosis (ALS), a fatal progressive and neurodegenerative disease. This adipokine has previously been shown to be associated with a lower risk of ALS disease and to confer a survival advantage in ALS patients. However, the role of leptin in the progression of ALS is unknown. Indeed, our understanding of the mechanisms underlying leptins effects in the pathogenesis of ALS is very limited, and it is fundamental to determine whether alterations in leptins actions take place in this neurodegenerative disease. To characterize the association between leptin signaling and the clinical course of ALS we assessed the mRNA and protein expression profiles of leptin, the long leptin receptor (Ob-Rb) and leptin-related signaling pathways over the time course of the disease (onset and end-stage of disease), in TDP-43A315T mice compared to age-matched WT littermates. In addition, at the selected time-points immunoassay analysis was conducted to characterize plasma levels of total ghrelin, the adipokines (resistin and leptin) and metabolic proteins (plasminogen activator inhibitor type 1 (PAI-1), gastric inhibitory peptide (GIP), glucagon like peptide 1 (GLP-1), insulin and glucagon) in TDP-43A315T mice compared to WT controls. Our results indicate alterations in leptin signaling in the spinal cord and the hypothalamus on the backdrop of TDP-43-induced deficits in mice, providing new evidence about the pathways that could link leptin signaling to ALS.

show abstract

“…The risk of suffering this disease as well as its prognosis and progression, have been related to metabolic alterations. In fact, the majority of ALS patients suffer from malnutrition, which has been identified as a negative prognostic factor [10,11], and is associated with low levels of leptin [12]. There is a direct association between leptin levels and survival in ALS patients [24].…”

Section: Discussionmentioning

confidence: 99%

“…The results showed an up-regulation of ghrelin in TDP-43 A315T after leptin treatment, which is an appetite-stimulating hormone. Low ghrelin plasmatic levels have been found in ALS patients [31], which may contribute to reduced total food intake, and consequently malnutrition observed in the majority of ALS patients [10,11]. Ghrelin administration promotes food intake in humans [32].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, even though obesity represents the second preventable mortality cause worldwide [8], there is growing evidence that being overweight or obese provides a survival advantage in ALS patients [9]. In contrast, the majority of ALS patients (16-55%) suffer from malnutrition, which has been identified as a negative prognostic factor [10,11], and is associated with low levels of leptin [12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Leptin Treatment in a Mouse Model of Tdp-43 Proteinopathy

Ferrer-Donato¹,

Contreras²,

Fernández³

et al. 2021

Preprint

View full text Add to dashboard Cite

Amyotrophic Lateral Sclerosis (ALS) is an irreversible neurodegenerative disease with no known cure. Recent studies suggest a strong metabolic component in ALS pathogenesis and have shown an inverse relationship between leptin levels and ALS progression, although the effects of leptin as a treatment have not yet been studied. Therefore, we aim to examine whether the acute treatment with leptin has beneficial effects on brain pathology and cognitive function in the transgenic TDP43A315T line of ALS. Mice were treated intranasally (IN) with 0.03mg/kg of leptin or vehicle (VH) daily for 7 days. Data showed a progressive decline in body weight and motor coordination in TDP43A315T mice. Moreover, Lep-treated TDP43A315T mice showed an earlier disease onset, along with an improvement in motor performance. Altered levels of some of the adipokines and metabolic proteins studied were found in TDP43A315T mice, which were differently expressed among Lep-treated and VH-treated animals. Furthermore, some correlations were found among the serum levels of this proteins in WT and TDP43A315T mice. As far as we know, this is the first pilot study to provide evidence of the therapeutic effect of leptin treatment in a mice model of ALS, although further studies are needed to expound on the underlying mechanisms.

show abstract

Malnutrition at diagnosis in amyotrophic lateral sclerosis (als) and its influence on survival: Using glim criteria

Cited by 35 publications

References 8 publications

Agreement between the GLIM criteria and PG-SGA in a mixed patient population at a nutrition outpatient clinic

Agreement between the GLIM criteria and PG-SGA in a mixed patient population at a nutrition outpatient clinic

Alterations in leptin signaling in Amyotrophic Lateral Sclerosis (ALS)

Effect of Leptin Treatment in a Mouse Model of Tdp-43 Proteinopathy

Contact Info

Product

Resources

About