Endocrine Abstracts

Introduction: ALS is a neurodegenerative disease with a high prevalence of malnutrition. Nutritional diagnosis is important because of its prognostic implication.

Objective: To determine the clinical and morphofunctional characteristics in a series of patients with ALS.

Materials and methods: Cross-sectional descriptive study of patients seen at the multidisciplinary ALS clinic of the Hospital Puerta del Mar (Cádiz).

Results: 17 patients, 58.8% women, mean age 68 years and weight 64.9 kg. The mean time of symptoms evolution was 39 months (64.7% spinal symptoms). Distribution according to disease stage: I 5.9%, II 35.3%, III 41.2% and IV 17.6%. The mean ALSFRS-R scale score 32 (moderate progression). 64.7% had dysphagia, with mean duration 6 months and 35.3% had nutritional risk or were classified as malnourished (The Subjective Global Assessment (SGA) B or C). Mean nutritional ultrasound parameters: (1) Anterior rectus quadriceps: area 3.17 cm², Y axis 1.07 cm, (2) Abdominal adipose tissue: total 1.73 cm and preperitoneal 0.55 cm, (3) Masseter: 1.12 cm. BIA: Phase angle 3.7º, Hydration 73.8%, Fat free mass 42.8%, Fat mass 23.1 kg, BCM 17.3 and ASMM 14.3 kg. Patients with SGA B or C had a higher weight percentage (11.1 vs 1.65%; P 0.032) and lower fat mass (16.7 vs 24.2 kg; P 0.039). There was a negative correlation between ALFRS-R score and preperitoneal fat (r=- 0.837, P<0.001), and positive correlations between weight and fat mass (r= 0.752, P<0.001), between lean mass and ASMM (r= 0.966, P<0.001) and between lean mass and BCM (r=0.776, P<0.001).

Conclusions: In our cohort, malnutrition is highly prevalent. Overall, there is a marked decrease in phase angle, with a significant reduction in fat mass in malnourished patients. The prognostic value of these findings in the follow-up of the disease needs to be assessed.