Body mass index, not dyslipidemia, is an independent predictor of survival in amyotrophic lateral sclerosis

Abstract

Introduction: Recent studies have provided conflicting data regarding the role of dyslipidemia in amyotrophic lateral sclerosis (ALS). The aim of this study was to determine whether cholesterol level are an independent predictor of survival in ALS. Methods: Cholesterol levels were measured in 427 ALS subjects from three clinical trial databases. Results: The LDL/HDL ratio did not decrease over time, despite significant declines in body mass index (BMI), forced vital capacity (FVC), and ALSFRS‐R. After adjusting for BMI, FVC, and age, the lipid ratio was not associated with survival. There was a “U”‐shaped association between BMI and mortality, with the highest survival at 30–35 kg/m². The adjusted hazard ratio for the linear association between BMI and survival was 0.860 (95% CI 0.80–0.93, P = 0.0001). Conclusions: We found that dyslipidemia is not an independent predictor of survival in ALS. BMI is an independent prognostic factor for survival after adjusting for markers of disease severity. Muscle Nerve, 2011