Abstract Details

While the relationship between ALS disease progression and body mass index (BMI) has been well documented, recent evidence suggests that changes in adipose tissue distribution may impact disease prognosis. The ratio of visceral to subcutaneous fat, previously measured by MRI or X-ray, has been found to be increased in PALS as compared to healthy controls, and within these patients, higher ratios predicted more advanced disease.

The goal of this study is to create an affordable and readily accessible tool to measure adipose tissue distribution and correlate this to symptomatic presentation and progression in ALS. We hypothesize that the BMI to waist girth ratio (BMI:WG) in ALS patients (PALS) correlates inversely to ALS disease severity.

The following data was collected from 47 Virginia Commonwealth University PALS: BMI:WG ratio, measures of disease severity including upright and supine vital capacity (UVC and SVC, respectively) and ALS functional rating scale revised (ALSFRS-R), and covariates such as age, sex, months since diagnosis, and bulbar or limb onset. To assess the association between the disease severity with the BMI:WG ratio we used a linear regression model adjusted for these variables.

After adjustment for the covariates, we found that BMI:WG has a significant inverse relationship with UVC (p-value = 0.0150), representing a direct relationship between BMI:WG.

This was a preliminary analysis of the relationship between BMI:WG ratio and three measures of ALS disease severity in PALS.  We found a significant inverse relationship between BMI:WG ratio and UVC, indicating that visceral fat acquisition may correspond to less severe disease presentation. This is the opposite of what we had predicted and warrants further investigation. Longitudinal data acquisition and analysis is ongoing. These results provide initial insights into the association between BMI:WG ratio and ALS disease measures.