Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
PLoS One. 2021 May 6;16(5):e0251087. doi: 10.1371/journal.pone.0251087. eCollection 2021.
BACKGROUND/OBJECTIVE: Weight loss is a predictor of shorter survival in amyotrophic lateral sclerosis (ALS). We performed serial measures of body composition using Dual-energy X-ray Absorptiometry (DEXA) in ALS patients to explore its utility as a biomarker of disease progression.
DEXA data were obtained from participants with ALS (enrollment, at 6- and 12- months follow ups) and Parkinson's disease (enrollment and at 4-month follow up) as a comparator group. Body mass index, total lean mass index, appendicular lean mass index, total fat mass index, and percentage body fat at enrollment were compared between the ALS and PD cohorts and age-matched normative data obtained from the National Health and Nutrition Examination Survey database. Estimated monthly changes of body composition measures in the ALS cohort were compared to those of the PD cohort and were correlated with disease progression measured by the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R).
The ALS cohort (N = 20) had lower baseline total and appendicular lean mass indices compared to the PD cohort (N = 20) and general population. Loss in total and appendicular lean masses were found to be significantly associated with follow-up time. Low baseline percentage body fat (r = 0.72, p = 0.04), loss of percentage body fat (r = 0.81, p = 0.01), and total fat mass index (r = 0.73, p = 0.04) during follow up correlated significantly with monthly decline of ALSFRS-R scores in ALS cohort who had 2 or more follow-ups (N = 8).
Measurement of body composition with DEXA might serve as a biomarker for rapid disease progression in ALS.
背景/目的：体重减轻是肌萎缩侧索硬化症（ALS）患者生存时间缩短的预测因素。我们对 ALS 患者进行了多次使用双能 X 射线吸收法（DEXA）的身体成分测量，以探索其作为疾病进展的生物标志物的效用。
从 ALS 患者（入组时，6 个月和 12 个月随访时）和帕金森病（入组时和 4 个月随访时）的参与者中获得 DEXA 数据作为对照组。将入组时的 BMI、总瘦体重指数、四肢瘦体重指数、总脂肪量指数和体脂百分比与 ALS 和 PD 队列进行比较，并与从国家健康和营养检查调查数据库获得的年龄匹配的正常数据进行比较。将 ALS 队列中身体成分测量的估计每月变化与 PD 队列进行比较，并与修订后的肌萎缩侧索硬化功能评定量表（ALSFRS-R）测量的疾病进展进行相关性分析。
与 PD 队列（N = 20）和一般人群相比，ALS 队列（N = 20）的基线总瘦体重指数和四肢瘦体重指数较低。总瘦体重和四肢瘦体重的丢失与随访时间呈显著相关。低基线体脂百分比（r = 0.72，p = 0.04）、体脂百分比的丢失（r = 0.81，p = 0.01）和总脂肪量指数（r = 0.73，p = 0.04）与 2 次或更多次随访的 ALS 队列中 ALSFRS-R 评分的每月下降显著相关（N = 8）。
DEXA 测量的身体成分可能是 ALS 快速疾病进展的生物标志物。
