Article

Body mass index, not dyslipidemia, is an independent predictor of survival in amyotrophic lateral sclerosis

Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Muscle & Nerve (Impact Factor: 2.31). 07/2011; 44(1):20-4. DOI: 10.1002/mus.22114
Source: PubMed

ABSTRACT Recent studies have provided conflicting data regarding the role of dyslipidemia in amyotrophic lateral sclerosis (ALS). The aim of this study was to determine whether cholesterol level are an independent predictor of survival in ALS.
Cholesterol levels were measured in 427 ALS subjects from three clinical trial databases.
The LDL/HDL ratio did not decrease over time, despite significant declines in body mass index (BMI), forced vital capacity (FVC), and ALSFRS-R. After adjusting for BMI, FVC, and age, the lipid ratio was not associated with survival. There was a "U"-shaped association between BMI and mortality, with the highest survival at 30-35 kg/m(2). The adjusted hazard ratio for the linear association between BMI and survival was 0.860 (95% CI 0.80-0.93, P = 0.0001).
We found that dyslipidemia is not an independent predictor of survival in ALS. BMI is an independent prognostic factor for survival after adjusting for markers of disease severity.

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    • "Dorst et al., 2011 N = 427 High BMI correlates to longer survival. Paganoni et al., 2011 N = 77 Fast reduction of BMI predicts faster decline. Shimizu et al., 2012 N = 150 High BMI correlate to slower ALSFRS score decline. "
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    • "Ces résultats vont dans le sens de travaux réalisés dans un modèle murin de SLA qui montrent un allongement important de la survie des souris lorsqu'est administré une diète hypercalorique et hyperlipidique [24]. Des travaux plus récents suggèrent que cette corrélation hyperlipidémie/survie est plus certainement une corrélation l'indice de masse corporelle (IMC)/survie et donc que l'hyperlipidémie ne serait pas un facteur pronostique indépendant [25]. L'étude de Pradat et al. [26] a observé, chez un tiers de leurs patients atteints de SLA étudiés, une intolérance anormale au glucose. "
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