Moțățăianu Anca, Mănescu Ion Bogdan, Șerban Georgiana, Ion Valentin, Bălașa Rodica, Andone Sebastian
Department of Neurology, University of Medicine, Pharmacy, Science and Technology of Târgu Mureș 'George Emil Palade', 540142 Târgu Mureș, Romania.
1st Neurology Clinic, Mures County Clinical Emergency Hospital, 540136 Târgu Mureș, Romania.
Nutrients. 2025 Apr 25;17(9):1437. doi: 10.3390/nu17091437.
: Amyotrophic lateral sclerosis (ALS) is a prevalent neurodegenerative disease but lacks effective treatments. Dietary interventions, notably the Mediterranean diet, promise to modulate disease pathways. This study aimed to investigate the impact of the Mediterranean diet on gut hormones and cytokines in patients with amyotrophic lateral sclerosis (ALS). : We conducted a 12-month, single-center prospective study on a total of 44 ALS patients. After a 6-month observation period, the patients were placed on a dairy-free Mediterranean diet for the next 6 months. We evaluated the patients at baseline (T0), 6 months (T1), and 12 months (T2). We measured the ALS Functional Rating Scale-Revised (ALSFRS-R) scores and a panel of metabolic hormones and cytokines. : The ALSFRS-R scores declined over 12 months (37.59 ± 6.32 at T0 vs. 30.23 ± 8.91 at T2, < 0.001), indicating expected disease progression with no significant difference in the rate of decline before and after the dietary intervention. The leptin levels significantly decreased from T0 to T1 (T0: 4956 ± 3994 pg/mL vs. T1: 3196 ± 2807 pg/mL, = 0.038). The insulin and GLP-1 levels showed significant drops at T2 (insulin T0: 480 ± 369 vs. T2: 214 ± 213 pmol/L, < 0.01; GLP-1 T0: 118 ± 76 vs. T2: 60 ± 57 pg/mL, < 0.01). C-peptide increased at T2 (T0: 3814 ± 1967 vs. T2: 9532 ± 4000 pg/mL, < 0.001). Among the cytokines, the levels of IL-12P70, IL-13, IL-9, and IL-2 significantly decreased from T0 to T2 (all < 0.05), while IL-17A and TNFα significantly increased between T1 and T2 ( < 0.01). : The Mediterranean diet intervention in ALS patients modulated several metabolic hormones and cytokines but with no evidence of impacting the disease's evolution or of a slowed clinical progression. These findings suggest a potential role for dietary intervention, particularly the Mediterranean diet, in modulating gut hormones and cytokines in ALS patients, but its impact on disease course is unclear. Future randomized studies are needed to confirm these changes and to determine whether dietary intervention can have any benefit in ALS.
肌萎缩侧索硬化症（ALS）是一种常见的神经退行性疾病，但缺乏有效的治疗方法。饮食干预，尤其是地中海饮食，有望调节疾病相关途径。本研究旨在调查地中海饮食对肌萎缩侧索硬化症（ALS）患者肠道激素和细胞因子的影响。
我们对总共44例ALS患者进行了一项为期12个月的单中心前瞻性研究。在6个月的观察期后，患者在接下来的6个月采用无乳制品的地中海饮食。我们在基线（T0）、6个月（T1）和12个月（T2）时对患者进行评估。我们测量了ALS功能评分量表修订版（ALSFRS-R）得分以及一组代谢激素和细胞因子。
ALSFRS-R得分在12个月内下降（T0时为37.59±6.32，T2时为30.23±8.91，<0.001），表明疾病按预期进展，饮食干预前后下降速率无显著差异。瘦素水平从T0到T1显著降低（T0：4956±3994 pg/mL，T1：3196±2807 pg/mL，P = 0.038）。胰岛素和GLP-1水平在T2时显著下降（胰岛素T0：480±369，T2：214±213 pmol/L，P<0.01；GLP-1 T0：118±76，T2：60±57 pg/mL，P<0.01）。C肽在T2时升高（T0：3814±1967，T2：9532±4000 pg/mL，P<0.001）。在细胞因子中，IL-12P70、IL-13、IL-9和IL-2的水平从T0到T2显著降低（均P<0.05），而IL-17A和TNFα在T1和T2之间显著升高（P<0.01）。
对ALS患者进行地中海饮食干预可调节多种代谢激素和细胞因子，但没有证据表明其对疾病进展有影响或能减缓临床进程。这些发现表明饮食干预，尤其是地中海饮食，在调节ALS患者肠道激素和细胞因子方面可能具有潜在作用，但其对疾病进程的影响尚不清楚。未来需要进行随机研究来证实这些变化，并确定饮食干预对ALS是否有任何益处。
