Serum levels of albumin and creatinine are independent biomarkers of disease severity in men and women with amyotrophic lateral sclerosis (ALS), according to a report published online ahead of print July 21 in JAMA Neurology. Lower levels of the chemicals denote more serious disease and predict a shorter survival time.
To identify potential correlations between hematologic biomarkers and ALS severity, researchers analyzed data for 638 patients from a regional registry of patients diagnosed between 2007 and 2011 in the Piemonte and Valle d’Aosta areas of Italy. The 352 men and 286 women underwent complete physical examinations at the time of diagnosis, which included tests for 17 serum biomarkers. The only two serum biomarkers that correlated with ALS severity were albumin level, which reflected inflammation, and creatinine, which reflected muscle wasting, said Adriano Chiò, MD, Associate Professor of Neuroscience at the University of Turin in Italy, and his associates.
Both biomarkers showed an inverse dose–response relationship with clinical function at diagnosis in men and women. The biomarkers had sensitivity and specificity values at predicting one-year mortality that were similar to those of “the best established prognostic factors” for ALS, such as forced vital capacity, age, and scores on the ALS Functional Rating Scale-Revised, said the investigators.
Dr. Chiò and his colleagues performed a validation study in a cohort of 122 patients (54 men and 68 women) at all stages of ALS who were treated at an ALS tertiary care center in Italy. This study confirmed the findings of the discovery cohort. “Creatinine and albumin are reliable and easily detectable blood markers of the severity of motor dysfunction in ALS and could be used in defining patients’ prognosis at the time of diagnosis,” the investigators stated.
—Mary Ann Moon