体重指数而非血脂异常是肌萎缩侧索硬化生存的独立预测因子。
Body mass index, not dyslipidemia, is an independent predictor of survival in amyotrophic lateral sclerosis.
机构信息
Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Muscle Nerve. 2011 Jul;44(1):20-4. doi: 10.1002/mus.22114. Epub 2011 May 23.
Abstract
INTRODUCTION
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.
METHODS
Cholesterol levels were measured in 427 ALS subjects from three clinical trial databases.
RESULTS
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).
CONCLUSIONS
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.
摘要
简介
最近的研究对血脂异常在肌萎缩侧索硬化症（ALS）中的作用提供了相互矛盾的数据。本研究旨在确定胆固醇水平是否为 ALS 患者生存的独立预测因素。
方法
从三个临床试验数据库中测量了 427 名 ALS 患者的胆固醇水平。
结果
尽管体重指数（BMI）、用力肺活量（FVC）和 ALSFRS-R 显著下降，但 LDL/HDL 比值并未随时间降低。在校正 BMI、FVC 和年龄后，脂质比值与生存率无关。BMI 与死亡率之间呈“U”形关联，BMI 在 30-35 kg/m²时存活率最高。BMI 与生存之间的线性关联的调整后危险比为 0.860（95%CI 0.80-0.93，P = 0.0001）。
结论
我们发现血脂异常不是 ALS 患者生存的独立预测因素。在校正疾病严重程度标志物后，BMI 是生存率的独立预后因素。
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