Serum levels of both albumin and creatinine proved to be independent biomarkers of disease severity in men and women with amyotrophic lateral sclerosis, with lower levels denoting more serious disease and a shorter survival time, according to a report published online July 21 in JAMA Neurology.
To identify any potential correlations between hematologic biomarkers and ALS severity, researchers analyzed data concerning 638 patients from a regional registry of people diagnosed during 2007-2011 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 found to correlate with ALS severity were albumin level, which reflected inflammation, and creatinine, which reflected muscle wasting, said Dr. Adriano Chio, professor of neuroscience, University of Torino, Turin, Italy, and his associates.
Both biomarkers showed an inverse dose-response relationship with clinical function at diagnosis in men and women. Both had sensitivity and specificity values at predicting 1-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, the investigators said (JAMA Neurol. 2014 July 21 [doi:10.1001/jamaneurol.2014.1129]).
Dr. Chio and his colleagues performed a validation study in a cohort of 122 patients (54 men, 68 women) at all stages of ALS who were treated at an ALS tertiary care center in another area of Italy. This study confirmed the findings from the discovery cohort. "Both 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," they said.
This study was supported by the Italian Ministry of Health and the European Community’s Health Seventh Framework Programme. Dr. Chio reported serving on scientific advisory board for Biogen Idec and Cytokinetics