Impacts of serum biomarkers regarding glucose, lipid and protein on progression and survival of amyotrophic lateral sclerosis: A Chinese cohort study

Abstract

Objective: To explore the impacts of nutritional biomarkers regarding glucose, protein and lipid on amyotrophic lateral sclerosis (ALS) progression and survival in a cohort of Chinese ALS patients.

Methods: A total of 191 ALS patients were included in our analysis. Pearson correlation was employed to analyze the relationships between baseline serological and clinical variables. Uni- and multivariate analysis were performed to analyze the influence of nutritional biomarkers on the progression and survival of ALS. A p-value of less than 0.05 was considered to be statistically significant.

Results: Hyperglycemia (around 1/6) and hyperlipidemia (1/5-1/3) were common among ALS patients while protein deficiency was not predominant. Serum total cholesterol (TC) (p=0.026) and low-density lipoprotein cholesterol (LDL-C) (p=0.044) was negatively related to baseline ALS functional rating scale-revised (ALSFRS-R) score, while serum PA was positively associated with baseline ALSFRS-R score (p=0.018). Serum levels of TC (p=0.041), apoB (p<0.001), lipoprotein a [Lp (a)] (p=0.002) and free fatty acids (FFA) (p=0.049) were negatively associated with baseline forced vital capacity percentage (FVC%). None of studied biomarkers showed significant relationship with ALS progression or survival time, except for serum level of Lp(a) had a weakly positive correlation to ALS progression rate after backward selection (p=0.048).

Conclusion: Serum biomarkers of glucose, lipid or protein might only have a weak relationship with autonomous function and respiratory function status, but have no significant impact on the progression or overall survival of ALS. More studies were needed to provide guidance of nutritional management and diet recommendation for ALS patients.