Impaired glucose tolerance in patients with amyotrophic lateral sclerosis.
Our objectives were to analyse carbohydrate metabolism in a series of ALS patients and to examine potential association with parameters of lipid metabolism and clinical features. Glucose tolerance was assessed by the oral glucose tolerance test in 21 non-diabetic ALS patients and compared with 21 age- and sex-matched normal subjects. Lipids and lactate/pyruvate ratio, levels of pro-inflammatory cytokines (tumour necrosis factor-alpha and interleukin-6) and adipocytokines (leptin and adiponectin) were also measured in ALS patients. Mann-Whitney U-tests analysed continuous data and Fisher's exact tests assessed categorical data. Blood glucose determined 120 min after the glucose bolus was significantly higher in patients with ALS (7.41 mmol/l+/-1.68) compared to controls (6.05+/-1.44, p=0.006). ALS patients with impaired glucose tolerance (IGT) according to WHO criteria (n=7, 33%) were more likely to have elevated free fatty acids (FFA) levels compared to patients with normal glucose tolerance (0.77 nmol/l+/-0.30 vs. 0.57+/-0.19, p=0.04). IGT was not associated with disease duration or severity. In conclusion, patients with ALS show abnormal glucose tolerance that could be associated with increased FFA levels, a key determinant of insulin resistance. The origin of glucose homeostasis abnormalities in ALS may be multifactorial and deserves further investigation.
Pradat
Pierre-Francois
PF
APHP, Hôpital de la Pitié-Salpêtrière, Fédération des Maladies du Système Nerveux, Paris, France. pierre-francois.pradat@psl.aphp.fr <pierre-francois.pradat@psl.aphp.fr>
Bruneteau
Gaelle
G
Gordon
Paul H
PH
Dupuis
Luc
L
Bonnefont-Rousselot
Dominique
D
Simon
Dominique
D
Salachas
Francois
F
Corcia
Philippe
P
Frochot
Vincent
V
Lacorte
Jean-Marc
JM
Jardel
Claude
C
Coussieu
Christiane
C
Le Forestier
Nadine
N
Lacomblez
Lucette
L
Loeffler
Jean-Philippe
JP
Meininger
Vincent
V
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000150:complications* / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D019289:Pyruvic Acid / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; C508600:IL6 protein, human; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid; D019289:Pyruvic Acid