Abstract
Adequate nutritional support and high body mass index (BMI) are good prognostic factors for disease progression and survival in amyotrophic lateral sclerosis (ALS). However, whether the composition of body weight, such as body fat percentage, has an independent effect on ALS prognosis remains unclear. The clinical data of 53 ALS patients were collected by medical record review. The data included: disease onset, sex, age, time of diagnosis, survival duration, presence of percutaneous endoscopic gastrostomy (PEG), nasogastric tube, tracheostomy, and availability of oral intake throughout the course of the disease, and interval measurement values of body mass by bioelectrical impedance analysis (BIA). The interval change (∆) of the BIA parameters was calculated by subtracting the follow-up values from the baseline values. Change in body fat percentage/interval between BIA measurements (months) (hazard ratio [HR] = 0.374, p = 0.0247), and availability of oral food intake (HR = 0.167, p = 0.02), were statistically significant for survival duration in multivariate hazard proportional regression analysis. Survival analysis and Kaplan–Meier curves showed similar results. Higher average monthly change in body fat percentage and availability of oral food intake are prognostic factors in ALS survival.
Highlights
Among 220 amyotrophic lateral sclerosis (ALS) patients who were admitted during the study period, 53 who satisfied the inclusion and exclusion criteria were included in the final analysis of the data (Figure 1)
We observed that the change in the parameters measured by bioelectrical impedance analysis (BIA) had a timeinterval relationship, that is, the tendency of increase (e.g., ∆ body fat percentage) or decrease (e.g., ∆ skeletal muscle index, ∆ muscle mass, ∆ fat-free mass, ∆ skeletal muscle mass, ∆ basal metabolism rate, and ∆ phase angle) in BIA parameters closely correlated with the time interval between the measurements
There is no clear study that considers the average monthly change in body fat percentage as a prognostic factor linked to survival duration in ALS patients using BIA
Summary
Previous studies have suggested that complete general care with adequate nutritional support could delay muscle mass loss, and increasing body weight or body mass index (BMI) may improve the prognosis for ALS patients [6,7,8,9]. These studies did not analyze the effect of each component of body weight (e.g., muscle mass, water, fat, etc.) on ALS prognosis
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