Endocrine Abstracts

JOINT2801

Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects functional, nutritional, and respiratory status. The assessment of respiratory parameters such as forced expiratory volume in one second (FEV₁), bioelectrical, and biochemical markers allows for determining their impact on disease progression and mortality.

Objectives: In a cohort of patients with autoimmune lateral sclerosis: To analyze the relationship between respiratory function parameters (FEV₁) and bioelectrical, biochemical, and clinical indicators. To assess the association between respiratory function and mortality.

Materials and Methods: A prospective cohort study was conducted in patients attending the multidisciplinary ALS clinic at Hospital Puerta del Mar (Cádiz). Baseline respiratory function tests and morphofunctional assessments were performed. Mortality was evaluated after a mean follow-up of 18 months.

Results: The cohort included 22 patients, 52.6% women, with a median age of 65 years and a mean weight of 64.7 kg (BMI 23.7). At disease onset, 68.1% presented spinal symptoms, and 72.7% had bulbar involvement at baseline assessment. The predominant disease stages were: stage II (45%) and stage III (27.2%). The median ALSFRS-R score was 35, indicating moderate progression. Dysphagia was present in 59% of patients, and 54% had nutritional risk or malnutrition (VSG B or C). After 18 months of follow-up, 31.8% of patients had died. Twelve patients (54.5%) had FEV₁ <80%, which was associated with more advanced disease stages III-IV (OR: 24.8 [1.17–52.6]; P = 0.006), moderate-to-severe ALSFRS-R scores (OR: 8.17 [1.03–64.9]; P = 0.037), and higher mortality (OR: 9 [0.84–94.9]; P = 0.045). FEV₁ showed a positive correlation with bioelectrical impedance vector analysis (BIVA) parameters, including phase angle (PhA) (r = 0.56; P = 0.008) and body cell mass (BCM) (r = 0.47; P = 0.033), and a negative correlation with C-reactive protein (CRP) levels (R=-0.754; P = 0.002).

Conclusion: FEV₁ correlates with biochemical and bioelectrical parameters, and values below 80% are associated with advanced ALS stages, greater disease severity, and increased mortality. Baseline FEV₁ assessment, combined with morphofunctional evaluation, may help identify patients at higher risk of poor disease progression, guiding the intensification of multidisciplinary treatment and closer monitoring.