The Relationship Of Amyotrophic Lateral Sclerosis And Nutrition Metabolism

Part 1.Abnormal Glucose Metabolism and The Risk of Amyotrophic Lateral Sclerosis: A Systematic ReviewObjective: To explore the relationship between abnormal glucose metabolism and the risk of amyotrophic lateral sclerosis(ALS).Methods: Studies were included through the systematic assessment and classified according to different research interests.Up-to-standard studies were analyzed quantitatively by metaanalysis.Results: 1.14 studies were included for descriptive analysis: 3 cohort studies and 5 casecontrol studies on the relationship between abnormal glucose metabolism and the onset of ALS indicate that diabetes could increase the risk of ALS onset in Asia group but decrease the risk in Western group.There were 4 cohort studies about the prognosis of ALS.There were no obvious associations between diabetes and ALS,except one research from China showed that glycosylated hemoglobin could increase the mortality risk in ALS.2.5 casecontrol studies were included into the meta-analysis,and the results showed that diabetes could decrease the risk of ALS onset(OR = 0.66,95% CI 0.51 ~ 0.85).Conclusion: Abnormal glucose metabolism has different influence in different phases of ALS.Generally,abnormal glucose metabolism tends to increase the risk of ALS in Asia and decrease the risk in the West.Part 2.The Relationship of Amyotrophic Lateral Sclerosis and Indexes of Nutrition MetabolismObjective: To explore the relationship between the indexes of nutrition metabolism and amyotrophic lateral sclerosis(ALS).Methods: 58 clinically definite or probable ALS patients,58 healthy controls and 58 patients with lacunar infarction were registered.General information and indexes of nutrition metabolism were collected.Single factor ?2 test and multivariable logistic regression analysis were used to analyze the association between ALS and those indexes.Results: 1.There are no significant differences of age and sex between ALS and the two groups of control(P > 0.05).2.ALS-healthy control:Fasting blood glucose(OR = 0.138,P = 0.021),high density lipoprotein cholesterol(HDL-C)(OR = 0.130,P = 0.004),albumin(OR=0.018,P=0.013),freethyroxine(FT4)(OR = 27.796,P < 0.001)and body mass index(BMI)(OR = 0.123,P = 0.003)are associated with ALS.3.ALS-patients with lacunar infarction:Fasting blood glucose(OR = 0.306,P = 0.044),HDL-C(OR = 0.255,P = 0.005),albumin(OR = 0.293,P = 0.027),homocysteine(HCY)(OR = 0.230,P = 0.027)and BMI(OR = 0.169,P < 0.001)are associated with ALS.Conclusion: Fasting blood glucose,HDL-C,albumin and BMI are associated with ALS independently,which are lower in ALS progression.