Endocrinology and Nutrition Unit, San Cecilio University Hospital, 18016 Granada, Spain.
Fundación para la Investigación Biosanitaria en Andalucía Oriental-Alejandro Otero (FIBAO), 18012 Granada, Spain.
Nutrients. 2024 Aug 9;16(16):2625. doi: 10.3390/nu16162625.
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease frequently accompanied by malnutrition due to weight loss, increased energy expenditure, and muscle mass loss. This study aimed to evaluate morphofunctional assessment tools as predictors of malnutrition and to investigate their relationship with muscle status and disease severity in ALS patients. A cross-sectional study was conducted with 45 ALS patients at the San Cecilio University Hospital in Granada. Malnutrition was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional assessment was performed using Bioimpedance Vectorial Analysis (BIVA), handgrip strength (HGS), and Short Physical Performance Battery (SPPB). Malnutrition prevalence was 38% according to GLIM criteria. Significant differences were observed between malnourished and non-malnourished groups in age (70 ± 9 vs. 62 ± 10 years, = 0.01), sex (female prevalence: 58.8% vs. 25.0%, = 0.02), dysphagia prevalence (83% vs. 29%, < 0.001), PEG/PRG use (35.3% vs. 3.6%, = 0.01), and ALSFRS-R scores (30 ± 12 vs. 34 ± 12, = 0.02). Malnourished patients had lower values in anthropometric measurements, muscle mass obtained by BIVA, and phase angle (PA) (4.05 ± 0.8° vs. 5.09 ± 0.8°, < 0.001). No significant differences were found in muscle strength or functional status. PA showed significant correlations with muscle strength (r = 0.52, < 0.001) and muscle mass measures (r = 0.48, < 0.001). Moreover, PA was associated with poorer disease progression and physical performance. In our sample, BIVA metrics such as PA (<4.3°), SPA (<-0.8), body cell mass (<9.2 kg/m), and extracellular water (>49.75%) were identified as malnutrition risk factors. The study underscores the critical importance of comprehensive morphofunctional assessment and the use of advanced diagnostic criteria, for early identification and intervention in malnutrition among people with ALS. Further research is warranted to validate these findings and develop targeted nutritional strategies into routine clinical practice.
肌萎缩侧索硬化症（ALS）是一种进行性神经退行性疾病，常因体重减轻、能量消耗增加和肌肉质量损失而导致营养不良。本研究旨在评估形态功能评估工具作为营养不良的预测因子，并研究其与 ALS 患者的肌肉状况和疾病严重程度的关系。在格拉纳达的圣塞西莉亚大学医院进行了一项横断面研究，共有 45 名 ALS 患者参与。使用全球营养不良倡议（GLIM）标准评估营养不良。使用生物电阻抗矢量分析（BIVA）、握力（HGS）和短体物理性能电池（SPPB）进行形态功能评估。根据 GLIM 标准，营养不良的患病率为 38%。在年龄（70±9 岁与 62±10 岁， = 0.01）、性别（女性患病率：58.8%与 25.0%， = 0.02）、吞咽困难患病率（83%与 29%， < 0.001）、PEG/PRG 使用（35.3%与 3.6%， = 0.01）和 ALSFRS-R 评分（30±12 与 34±12， = 0.02）方面，营养不良组与非营养不良组存在显著差异。营养不良患者的人体测量学测量值、BIVA 获得的肌肉质量和相位角（PA）较低（4.05±0.8°与 5.09±0.8°， < 0.001）。肌肉力量或功能状态无显著差异。PA 与肌肉力量（r = 0.52， < 0.001）和肌肉质量测量值（r = 0.48， < 0.001）显著相关。此外，PA 与疾病进展和身体表现较差相关。在我们的样本中，BIVA 指标，如 PA（<4.3°）、SPA（<-0.8）、体细胞质量（<9.2kg/m）和细胞外水（>49.75%）被确定为营养不良的危险因素。该研究强调了全面形态功能评估和使用先进诊断标准的重要性，以便早期识别和干预 ALS 患者的营养不良。需要进一步的研究来验证这些发现，并将有针对性的营养策略纳入常规临床实践。
