TORNA ALL’ELENCO

The role of albumin and creatinine in a population-based cohort of ALS patients in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

2014
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (20)Vedi tutti...

Calvo A

Bovio G

Canosa A


et alii...

Abstract

Background: There is an urgent need to identify reliable biomarkers of Amyotrophic Lateral Sclerosis (ALS) progression both for clinical practice and pharmacological trials. Objective: To correlate several haematological markers evaluated at diagnosis with ALS outcome in a population-based series of patients ( 'discovery' cohort). To replicate the findings in an independent 'validation cohort' from an ALS tertiary center. Methods: The discovery cohort included ALS patients from the Piemonte/Valle d' Aosta Register for ALS, in the 2007 - 2011 period. The validation cohort comprised 122 ALS patients at different stages of disease consecutively seen at an ALS tertiary center between 2007 and 2009.The following haematological factors were investigated and correlated to survival: total leukocytes; neutrophils; lymphocytes; monocytes; glucose; creatinine; uric acid; albumin; bilirubin; total cholesterol; triglycerides; high density lipoproteins; low density lipoproteins; creatine kinase; thyroid stimulating hormone; and erythrocyte sedimentation rate (ESR); all analyses were performed separately for gender. The patients in the validation cohort also underwent bioelectrical impedance analysis for the calculation of fat-free mass (FFM). Results: Of the 712 incident patients in the examined period in Piemonte/Valle d' Aosta, 638 (89.6%) were included in the study. Only serum albumin, serum creatinine and lymphocyte count were significantly related to ALS outcome in both genders, with a dose-response effect (better survival with increasing levels). These findings were confirmed in the validation cohort. Multivariable analysis showed that serum albumin and creatinine were independent predictors of survival in both genders; no other hematological factor was retained in the model. In ALS patients, serum albumin was correlated with markers of inflammatory state, while serum creatinine was correlated with FFM, which is a marker of muscle mass. Discussion and conclusion: In

DOI : 10.3109/21678421.2014.960172/054

Keywords

creatinine; albumin; marker; serum albumin; low density lipoprotein; high density lipoprotein; bilirubin; uric acid; glucose; triacylglycerol; thyrotropin; creatine kinase; biological marker; human; patient; prognosis; population; Tertiary (period); gender; survival; diagnosis; X ray bone densitometer; creatinine blood level; muscle; cholesterol blood level; monocyte; register; lymphocyte; clinical practice; model; neutrophil; amyotrophic lateral sclerosis; fat free mass; leukocyte; erythrocyte sedimentation rate; impedance; lymphocyte count; dose response; waste; non implantable urine incontinence electrical stimulator;