Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York2Clinical Research Center, Helen Hayes Hospital, West Haverstraw, New York.
Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA Neurol. 2016 Dec 1;73(12):1425-1432. doi: 10.1001/jamaneurol.2016.3401.
There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS).
To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less.
Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ).
Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale-Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC).
Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses.
Antioxidants, carotenes, fruits, and vegetables were associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis. We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes.
人们对营养在肌萎缩侧索硬化症（ALS）的发病机制和进展中的作用越来越感兴趣。
评估营养素个体和群体与 ALS 功能和诊断时呼吸功能之间的关联。
设计、地点和参与者：对美国 16 个 ALS 诊所的 302 名 ALS 患者进行了横断面基线分析，这些患者的 ALS 症状持续时间为 18 个月或更短，研究时间为 2008 年 3 月 14 日至 2013 年 2 月 27 日。
使用改良的 Block 食物频率问卷（FFQ）测量营养素摄入量。
使用肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）测量肌萎缩侧索硬化症功能，使用预计用力肺活量百分比（FVC%）测量呼吸功能。
共纳入 302 名 ALS 患者的基线数据（中位年龄 63.2 岁[四分位间距 55.5-68.0 岁]；178 名男性和 124 名女性）。回归分析发现，抗氧化剂和蔬菜类胡萝卜素的摄入量较高与 ALSFRS-R 评分或 FVC%较高有关。采用加权分位数和回归方法的“良好”微量营养素和“良好”食物组经验加权指数与 ALSFRS-R 评分呈正相关（β[SE]分别为 2.7[0.69]和 2.9[0.9]）和 FVC%（β[SE]分别为 12.1[2.8]和 11.5[3.4]）（均 P<0.001）。探索性分析显示，与 ALSFRS-R 评分（β[SE]，1.5[0.61]；P=0.02）和 FVC%（β[SE]，5.2[2.2]；P=0.02）呈正相关且有统计学意义的选定维生素也存在于相关性分析中。
通过回归分析和加权分位数和回归分析，抗氧化剂、类胡萝卜素、水果和蔬菜与基线时的 ALS 功能较高相关。我们还证明了加权分位数和回归分析方法在评估饮食方面的有用性。负责 ALS 患者营养护理的人员应考虑促进水果和蔬菜的摄入，因为它们富含抗氧化剂和类胡萝卜素。
