Bottom Line: The blood biomarkers serum creatinine and albumin appear to be associated with survival in amyotrophic lateral sclerosis (ALS) patients and may help define prognosis in patients after they are diagnosed with the fatal neurodegenerative disorder commonly known as Lou Gehrig disease.
Author: Adriano Chiō, M.D., of the Rita Levi Montalcini Department of Neuroscience, Torino, Italy, and colleagues.
Background: The median survival time of patients with ALS is 2 to 4 years from onset and 1 to 3 years from diagnosis. Therefore, there is a need to identify reliable biomarkers of ALS progression for clinical practice and pharmacological trials.
How the Study Was Conducted: The authors examined blood markers at ALS diagnosis in a population-based group of patients (discovery cohort, n=712) in Italy and then replicated the findings in another group of patients (validation cohort, n=122) from an ALS tertiary center. The blood markers examined included total leukocytes, glucose, cholesterol, albumin, creatinine and thyroid-stimulating hormones.
Results: Serum albumin and creatinine levels were related to ALS survival in both sexes. Creatinine reflected muscle waste and albumin was related to inflammation. Lower albumin and creatinine levels are related to worse clinical function at diagnosis. Discussion: "Both creatinine and albumin are reliable and easily detectable blood markers of the severity of motor dysfunction in ALS and could be used in defining patients' prognosis at the time of diagnosis. Longitudinal studies on the variations in serum albumin and creatinine levels and their relationships to clinical status will help determine whether and how these hematological factors vary during the progression of the disease." (JAMA Neurol
Published online July 21, 2014. doi:10.1001/.jamaneurol.2014.1129. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: An author made a conflict of interest disclosure. This work was in part supported by a grant and the Joint Programme Neurodegenerative Disease Research from the Italian Ministry of Health and a grant from the European Community's Health Seventh Framework Programme. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.