Dietary inflammatory index and prognosis of amyotrophic lateral sclerosis patients

Abstract

Neuroinflammation is one of the key mechanisms contributing to amyotrophic lateral sclerosis (ALS) pathophysiology. The present study was designed to evaluate the hypothesis that dietary inflammatory index (DII) score is correlated with disease progression rate or survival time, and inflammatory biological marker in ALS patients. A total of 214 sporadic ALS participants diagnosed according to the revised EI Escorial criteria were recruited from 2011, and followed at time of death or the end of January 2020, whichever came first. The events were defined when a participant died or had percutaneous endoscopic gastrostomy or tracheostomy. DII score was calculated based on 24-h dietary recall. The DII score was positively correlated with disease progression rate. The log-rank test showed that participants with the lowest DII tertile had longer events-free (P = 0.003) and tracheostomy-free survival (P = 0.015) than those with the middle and highest DII tertiles. In addition, there was a positive trend between DII score and risk of event after adjusted for confounding factors in multivariate analysis (HR 1.12; 95% CI 0.99-1.28; P for trend = 0.077). Cerebrospinal fluid levels of pro-inflammatory cytokines such as interleukin (IL)-1β, IL-6, IL-8, monocyte chemoattractant protein-1, and tumor necrosis factor alpha-α were significantly lower, but anti-inflammatory cytokines such as IL-10 and transforming growth factor-β1 were higher in the participants with the lowest than the highest DII tertile. The present study showed that anti-inflammatory diet was associated with prognosis such as disease progression rate and survival time in ALS patients.