肌萎缩侧索硬化
内科学
脂质代谢
医学
危险系数
血脂谱
胆固醇
胃肠病学
血脂
比例危险模型
疾病
内分泌学
肿瘤科
置信区间
作者
Mark R. Janse van Mantgem,Wouter van Rheenen,Anemone V Hackeng,Michael A. van Es,Jan H. Veldink,Leonard H. van den Berg,Ruben P A van Eijk
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2023-03-07
卷期号:100 (10)
被引量:8
标识
DOI:10.1212/wnl.0000000000201657
摘要
Objective:
To explore the association between lipids, polygenic profile scores (PPS) for biomarkers of lipid metabolism, markers of disease severity, and survival in patients with Amyotrophic Lateral Sclerosis (ALS). Methods:
We meta-analyzed the current literature on the prognostic value of lipids in patients with ALS. Subsequently, we evaluated the relationship between lipid levels at diagnosis, clinical disease stage and survival in all consecutive patients diagnosed in The Netherlands. We determined the hazard ratio of each lipid for overall survival, defined as death from any cause. A subset of patients was matched to a previous Genome Wide Association Study (GWAS); data were used to calculate PPS for biomarkers of lipid metabolism, and to determine the association between observed lipid levels at diagnosis and survival. Results:
Meta-analysis of four studies indicated that none of the biomarkers of the lipid metabolism were statistically significantly associated with overall survival; there was, however, considerable heterogeneity between study results. Using individual patient data (N = 1,324), we found that increased HDL-cholesterol was associated with poorer survival (HR of 1.33 (95% CI 1.14 to 1.55, p < 0.001)). The correlation between BMI and HDL-cholesterol (Pearson’s r -0.26, 95% CI -0.32 to -0.20) was negative, and between BMI and triglycerides positive (Pearson’s r 0.18, 95% CI 0.12 to 0.24). Serum concentrations of total cholesterol and LDL-cholesterol were lower in more advanced clinical stages (both p < 0.001). PPS for biomarkers of lipid metabolism explained 1.2% to 13.1% of their variance at diagnosis. None of the PPS were significantly associated with survival (all p > 0.50). Conclusions:
Lipids may contain valuable information about disease severity and prognosis, but their main value may be driven as a consequence of disease progression. Our results underscore that gaining further insight into lipid metabolism and longitudinal data on serum concentrations of the lipid profile could improve the monitoring of patients and potentially further disentangle ALS pathogenesis.
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