Relationships between Disease Progression and Serum Levels of Lipid, Urate, Creatinine and Ferritin in Japanese Patients with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study
Relationships between Disease Progression and Serum Levels of Lipid, Urate, Creatinine and Ferritin in Japanese Patients with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study
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DOI：
10.2169/internalmedicine.51.7465
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发表时间：
2012-01-01
影响因子：
1.2
通讯作者：
Iwasaki, Yasuo
中科院分区：
文献类型：
--
作者：
Ikeda, Ken;Hirayama, Takehisa;Iwasaki, Yasuo
目的以往的研究报道了西方肌萎缩侧索硬化症(ALS)患者的血脂、尿酸和铁蛋白的不同血清学特征。我们旨在检测日本ALS患者中这些血清学因素的水平及其与疾病进展的关系。方法对92例符合修订的El Ecorial标准的确诊或可能的ALS患者的临床和血清学变量进行分析。结果与对照组相比，ALS患者的血尿酸和肌酐水平显著降低，铁蛋白水平显著升高。女性ALS患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯水平显著升高。ALS功能评定量表(ALS-FRS)和用力肺活量(FVC)的年下降与血清TC、LDL-C、Cr和尿酸水平呈负相关，与血清铁蛋白水平呈正相关。多因素分析显示，ALS-FRS和FVC的快速恶化与血清TC、LDL-C、Cr、尿酸和铁蛋白水平有关。结论血清TC、LDL-C、Cr、尿酸和铁蛋白水平与ALS患者的临床恶化密切相关。这些结果与西方患者的结果相似。脂肪、尿酸盐和铁的代谢和营养状况可能促进ALS患者的疾病进展。进一步研究高营养饮食和铁络合物治疗ALS是有必要的。
Objective Previous studies have reported distinct serological profiles of lipid, urate and ferritin in Western patients with amyotrophic lateral sclerosis (ALS). We aimed to examine the levels of these serological factors and their relationship to disease progression in Japanese ALS patients.Methods Ninety-two patients with definite or probable ALS who fulfilled the revised El Escorial criteria were analyzed for clinical and serological variables. Serological data at the time diagnosed with ALS were compared to those of 92 age/sex/body mass index-matched healthy controls.Results Compared to controls, urate and creatinine (Cr) levels were decreased and ferritin levels were increased significantly in sera of male and female patients with ALS. Significant increases of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglyceride levels were found in female ALS patients. The annual decline of ALS Functional Rating Scale-Revised (ALS-FRS) and forced vital capacity (FVC) were inversely correlated with serum TC, LDL-C, Cr and urate levels, and were positively correlated with serum ferritin levels. Multivariate analysis showed that the rapid worsening of annual ALS-FRS and FVC was associated with serum levels of TC, LDL-C, Cr, urate and ferritin.Conclusion The present study indicated that serum levels of TC, LDL-C, Cr, urate and ferritin were correlated with clinical deterioration in ALS patients. These results are similar to those in Western patients. Metabolic and nutritional conditions of lipid, urate and iron could contribute to disease progression in ALS patients. Further studies investigating high nutrition diets and iron chelation for the treatment of ALS are warranted.