Higher ‘good’ cholesterol lowers ALS survival People with advanced disease have lower levels of ‘bad’ cholesterol

Elevated high-density lipoprotein (HDL) (commonly referred to as “good” cholesterol) levels are significantly associated with poor patient survival. amyotrophic lateral sclerosis (ALS), according to a Dutch population-based survey.

In contrast, total cholesterol and low-density lipoprotein (“bad” cholesterol) levels were lower in those with more advanced disease.

This finding suggests that lipids or fat molecules “may contain valuable information about disease severity and prognosis. [blood] The concentration appears to be dependent on the severity of the disease,” the researchers wrote.

However, the team noted that their findings may contradict previous studies. The higher the good cholesterol level, the lower the risk Or if.

“As our results are inconsistent with previous studies on the causal effect of lipid profile on ALS disease progression, this new information may contribute to ongoing efforts to elucidate the pathogenesis of ALS.” I believe there is [disease development]’” wrote the researcher.

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Study of good and bad cholesterol in ALS

new researchAssociation between serum lipids and survival in patients with amyotrophic lateral sclerosis: a meta-analysis and population-based study.was published in a magazine neurology.

Lipids are essential components of cell membranes. It also functions as a molecular messenger and energy source and is required for the normal functioning of cells, including nerve cells.

A number of studies have suggested a link between ALS and lipid metabolism, with higher lipid levels associated with a more aggressive disease course. However, other studies do suggest that lipids can exert protective effects.

To further clarify this association, a team of Dutch researchers first conducted a systematic review and meta-analysis of published studies up to June 2022. Their aim was to assess the prognostic value of biomarkers of lipid metabolism in ALS. It is a form of analysis that combines data from multiple studies to increase the statistical confidence of the results.

The team then investigated the prognostic value of specific lipid molecules in a group of patients diagnosed with ALS at Utrecht University Medical Center from 2012 to 2017.

From a total of 624 studies, 9 were considered for systematic review. Five of them showed significant associations between survival and circulating levels of triglycerides, total cholesterol, HDL, and LDL/HDL ratio.

A total of four studies with a total of 1120 patients were included in the meta-analysis. No statistically significant associations were found between lipid biomarkers (total cholesterol, HDL, LDL, triglycerides) and overall survival.

However, the researchers noted that there was “considerable heterogeneity among the findings.”

This population-based study enrolled 1,324 ALS patients, of whom 1,185 (89.5%) died by July 2020. In this population, the median survival from diagnosis he had was 16.5 months.

Overall, 20.1% of patients had elevated total cholesterol levels on the day of diagnosis. Of those, 42% had elevated levels of her LDL and 19.2% had elevated triglycerides. Additionally, his 4.9% of patients showed a decrease in his HDL levels at diagnosis.

After adjusting for potential confounders such as age, disease progression, ALS mutations, and lung function, the researchers found that a 1 millimole per liter (mmol/L) increase in HDL was associated with a 33% higher risk of death and ALS. Short survival after diagnosis.

This effect was more pronounced in women, where a 1 mmol/L increase in HDL was associated with a 48% higher risk of death, but was not affected by age at diagnosis.

Among the 419 patients with available disease progression measures, the rate of progression decreased by 0.79 points per month on the ALS Functional Rating Scale-Revised (ALSFRS-R).

However, the analysis showed that for every 1 mmol/L increase in HDL, the rate of progression of the ALSFRS-R score increased by 0.10 points. No association was seen with any of the remaining lipid biomarkers.

Gaining more insight into lipid metabolism may improve patient monitoring.

Finally, in exploratory analyses, the team assessed how genes influence biomarkers of lipid metabolism. This is a parameter called polygenic profile score (PPS).

An analysis of 688 ALS patients showed that each PPS was significantly correlated with the respective levels of lipid molecules (total cholesterol, HDL, LDL, and triglycerides). However, PPS showed no association with overall survival, suggesting that “lipid levels change as a result of disease rather than as a result of disease,” the researchers wrote.

“Gain more insight into lipid metabolism and longitudinal data [collected at different periods] Examining serum concentrations for lipid profiles may improve patient monitoring,” they wrote.