title: Nutritional status independently affects quality of life of patients with systemic immunoglobulin light-chain (AL) amyloidosis.
abstract: Nutritional status is an independent prognostic factor in immunoglobulin light-chain amyloidosis (AL), but its influence on quality of life (QoL) is unknown. The aim of this cross-sectional study was to investigate the association between nutritional status and QoL in AL patients at diagnosis. One hundred and fifty consecutive patients with biopsy-proven AL were assessed for nutritional status by anthropometry [body mass index, unintentional weight loss (WL) in the previous 6 months and mid-arm muscle circumference (MAMC)], biochemistry (serum prealbumin), and semiquantitative food intake at referral. QoL was assessed by the Medical Outcomes Study 36-item Short Form General Health Survey. The composite physical component summary (PCS) and the mental component summary (MCS) for AL outpatients were 36.2 ± 10.1 and 44.9 ± 11.3, respectively (p < 0.001 for both vs the population norms of 50). In multivariate linear regression models adjusted for gender, age, Eastern Cooperative Oncology Group performance status, the number of organs involved, the severity of cardiac damage, C-reactive protein, energy intake, and WL, PCS was significantly lower for serum prealbumin <200 mg/L and MAMC <10th percentile (adjusted difference 3.8, 95% CI 0.18-7.5, p = 0.040 and 5.3, 95% CI 2.0-8.7, p = 0.002, respectively). MCS was decreased by 0.47 (95% CI 0.18-0.75, p = 0.002) for each kilogram of body weight lost in the previous 6 months. Nutritional status independently affects QoL in AL patients since diagnosis. Nutritional evaluation should be integral part of the clinical assessment of AL patients. Nutritional support intervention trials are warranted in such patients' population.
authors.affiliation: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. r.caccialanza@smatteo.pv.it
authors.forename: Riccardo
authors.initials: R
authors.lastname: Caccialanza
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palladini
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.forename: Chiara
authors.initials: C
authors.lastname: Bonardi
authors.forename: Barbara
authors.initials: B
authors.lastname: Cameletti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Montagna
authors.forename: Paola
authors.initials: P
authors.lastname: Russo
authors.forename: Andrea
authors.initials: A
authors.lastname: Foli
authors.forename: Paolo
authors.initials: P
authors.lastname: Milani
authors.forename: Francesca
authors.initials: F
authors.lastname: Lavatelli
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000473:pathology* / Q000503:physiopathology*; D000886:Anthropometry; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D007147:Immunoglobulin Light Chains