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Epidémiologie de la Sclérose Latérale Amyotrophique : incidence, mortalité et facteurs pronostiques nutritionnels de survie.

Abstract : To date, few data have been published on the incidence of Amyotrophic lateral sclerosis in France. Clinically, progression of ALS is marked by a progressive deterioration in nutritional status. However, the value of new nutritional markers (such as the phase angle) should be considered, and our understanding of changes in nutritional status during the course of the disease remains fragmentary- During our PhD Thesis we performed an epidemiological descriptive study, a geoepiemiological study, two reviews and two prognostic studies. When age-standardized for the 1999 French population, the mean annual incidence was 2.0/100,000 inhabitants (95% confidence interval (CI): 1.8-2.3). We also identified three clusters of ALS in Limousin. Phase angle is altered in ALS patients as compared to healthy controls and is independently associated with survival. We also demonstrated a significant weight loss at diagnosis, a progressive worsening of this parameter during the course and a significant and independent prognostic value of weight loss measured at diagnosis with a 30% increased risk of death for a 5% decrease from usual weight. One of our perspectives is to establish a registry of ALS in Limousin. A second perspective involves, using the ALS clusters we identified, to examine the possible link between ALS and L-BMAA cyanotoxin. Finally, concerning nutritional aspects of ALS our results support (i) early consideration of making assessment of the patient's weight and weight loss part of daily routine, and (ii) the establishment of experimental studies aiming to reverse weight loss and alter body composition of patients as quickly as possible after diagnosis.
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Submitted on : Tuesday, March 15, 2016 - 11:02:49 AM
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  • HAL Id : tel-01288469, version 1



Benoît Marin. Epidémiologie de la Sclérose Latérale Amyotrophique : incidence, mortalité et facteurs pronostiques nutritionnels de survie.. Santé publique et épidémiologie. Ecole Doctorale n° 523 Gay Lussac "Sciences pour l'environnement", 2011. Français. ⟨NNT : 2011LIMO310C⟩. ⟨tel-01288469⟩



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