title: Adipose Tissue Distribution Predicts Survival in Amyotrophic Lateral Sclerosis.
abstract: amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that leads to death within a few years after diagnosis. Malnutrition and weight loss are frequent and are indexes of poor prognosis. Total body fat and fat distribution have not been studied in ALS patients.
  
  
  
  Our aim was to describe adipose tissue content and distribution in ALS patients.
  
  
  
  We performed a cross-sectional study in a group of ALS patients (n = 62, mean disease duration 22 months) along with age and gender matched healthy controls (n = 62) using a MRI-based method to study quantitatively the fat distribution.
  
  
  
  Total body fat of ALS patients was not changed as compared with controls. However, ALS patients displayed increased visceral fat and an increased ratio of visceral to subcutaneous fat. Visceral fat was not correlated with clinical severity as judged using the ALS functional rating scale (ALS-FRS-R), while subcutaneous fat in ALS patients correlated positively with ALS-FRS-R and disease progression. Multiple regression analysis showed that gender and ALS-FRS-R, but not site of onset, were significant predictors of total and subcutaneous fat. Increased subcutaneous fat predicted survival in male patients but not in female patients (p<0.05).
  
  
  
  Fat distribution is altered in ALS patients, with increased visceral fat as compared with healthy controls. Subcutaneous fat content is a predictor of survival of ALS patients.
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindauer
authors.forename: Luc
authors.initials: L
authors.lastname: Dupuis
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Müller
authors.forename: Heiko
authors.initials: H
authors.lastname: Neumann
authors.forename: Albert C
authors.initials: AC
authors.lastname: Ludolph
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality* / Q000503:physiopathology; D050218:Body Fat Distribution / Q000401:mortality*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D050151:Subcutaneous Fat / Q000503:physiopathology*; D015996:Survival Rate