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Hypermetabolism is a reality in amyotrophic lateral sclerosis compared to healthy subjects

Abstract : Rationale Hypermetabolism (HM) in Amyotrophic lateral sclerosis (ALS) is the reflection of a high energy metabolic level, but this alteration seems controversial. The main objective of the study was to confirm the existence of HM during ALS compared to healthy subjects. Methods A cohort of ALS patients was compared to a control group without metabolic disorder. The assessment included anthropometric criteria measurements, body composition by bioelectric impedance analysis and resting energy expenditure (REE) by indirect calorimetry. HM was defined as a variation > +10% between measured and calculated REE. Statistical analysis used Mann-Withney and Chi2 tests. Multivariate analysis included logistic regression. Results 287 patients and 75 controls were included. The metabolic level was higher in ALS patients (1500 kcal/24 h [1290–1693] vs. 1230 kcal/24 h [1000–1455], p < 0.0001) as well as the REE/fat free mass ratio (33.5 kcal/kg/24 h [30.4–37.8] vs. 28.3 kcal/kg/24 h [26.1–33.6], p < 0.0001). 55.0% of ALS patients had HM vs. 13.3% of controls (p < 0.0001). HM was strongly and positively associated with ALS (OR = 9.50 [4.49–20.10], p < 0.0001). Conclusions HM in ALS is a reality, which affects more than half of the patients and is associated with ALS. This work confirms a very frequent metabolic deterioration during ALS. The identification of HM can allow a better adaptation of the patients' nutritional intake.
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Soumis le : lundi 7 décembre 2020 - 11:02:54
Dernière modification le : mercredi 31 mars 2021 - 09:55:11

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Philippe Fayemendy, Benoit Marin, Anaïs Labrunie, Yves Boirie, Stéphane Walrand, et al.. Hypermetabolism is a reality in amyotrophic lateral sclerosis compared to healthy subjects. Journal of the Neurological Sciences, Elsevier, 2021, 420, pp.117257. ⟨10.1016/j.jns.2020.117257⟩. ⟨hal-03043219⟩

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