title: A prospective study of nutritional status in immunoglobulin light chain amyloidosis.
abstract: Weight loss is common in systemic immunoglobulin light chain amyloidosis but there are limited data on the impact of nutritional status on outcome. Using the Patient-Generated Subjective Global Assessment (PG-SGA) score, we prospectively examined nutritional status in 110 consecutive newly-diagnosed, treatment-naïve patients with immunoglobulin light chain amyloidosis attending the UK National Amyloidosis Centre. At study entry, 72 of 110 (66%) patients had a PG-SGA score of 4 or over, indicating malnutrition requiring specialist nutritional intervention. Number of amyloidotic organs, elevated alkaline phosphatase, presence of autonomic neuropathy and advanced Mayo disease stage were independently associated with poor nutritional status (P<0.05). Quality of life was substantially poorer among those with higher PG-SGA scores (P<0.001). Furthermore, PG-SGA score was a powerful independent predictor of patient survival (P=0.02). Malnutrition is prevalent and is associated with poor quality of life and reduced survival among patients with systemic immunoglobulin light chain amyloidosis. The PG-SGA score would be an appropriate tool to evaluate whether nutritional intervention could improve patient outcomes.
authors.affiliation: National Amyloidosis Centre, Centre for Amyloidosis & Acute Phase Proteins, University College London, UK.
authors.forename: Prayman T
authors.initials: PT
authors.lastname: Sattianayagam
authors.forename: Thirusha
authors.initials: T
authors.lastname: Lane
authors.forename: Zoe
authors.initials: Z
authors.lastname: Fox
authors.forename: Aviva
authors.initials: A
authors.lastname: Petrie
authors.forename: Simon D J
authors.initials: SD
authors.lastname: Gibbs
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Pinney
authors.forename: Signe S
authors.initials: SS
authors.lastname: Risom
authors.forename: Dorota M
authors.initials: DM
authors.lastname: Rowczenio
authors.forename: Ashutosh D
authors.initials: AD
authors.lastname: Wechalekar
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Lachmann
authors.forename: Janet A
authors.initials: JA
authors.lastname: Gilbertson
authors.forename: Philip N
authors.initials: PN
authors.lastname: Hawkins
authors.forename: Julian D
authors.initials: JD
authors.lastname: Gillmore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000235:genetics* / Q000276:immunology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000276:immunology*; D011446:Prospective Studies
chemical_list: D007147:Immunoglobulin Light Chains