P147 - THE IMPACT OF BLOOD LIPID CLASSES ON RISK OF AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND GRADE ANALYSIS

P147

THE IMPACT OF BLOOD LIPID CLASSES ON RISK OF AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND GRADE ANALYSIS

A. Sewell-Green^1,2,*, M. Kuiper³, A. Beelan³, F. Steyn^1,4, S. Ngo^4,5, K. Matthews-Rensch^2,6

¹School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, ²Department of Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, Brisbane, Australia, ³Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Centre Utrecht, Utrecht, Netherlands, ⁴Department of Neurology, Royal Brisbane and Women’s Hospital, ⁵Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, ⁶Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Brisbane, Australia

Rationale: Amyotrophic Lateral Sclerosis (ALS) is associated with altered lipid metabolism¹. This systematic review evaluated blood lipid classes on risk of ALS.

Methods: Following PRISMA guidelines, six databases (PubMed, Embase, CINAHL, Scopus, Cochrane Library, and Web of Science) were searched in March 2024. MeSH terms “Amyotrophic Lateral Sclerosis” AND “Lipids” and related variants were applied. Adult clinical studies reporting statistical risk of ALS were included. Baseline lipid levels were compared and descriptive statistics applied, categorising findings into reduced, no effect, or increased risk of ALS. GRADE criteria assessed confidence in evidence.

Results: Searches (n=6,454 studies) yielded eight eligible studies (n=7 sterol lipids, n=1 fatty acids). Baseline sterol lipid levels; total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or LDL/HDL ratio (I²= 67.7%-97.6%) were not significantly different. After removing high-bias studies, results were heterogeneous; no effect on risk for TG (n=4/5), TC (n=3/6), LDL-C (n=3/6), LDL/HDL (n=2/4), HDL-C (no effect, reduced risk, and increased risk of ALS n=2/6 each). Remaining studies suggested higher sterols increased ALS risk. One study showed increased risk with higher arachidonic acid and reduced risk with higher alpha-linoleic acid levels. GRADE of evidence was low for sterol lipids, and very low for fatty acids.

Conclusion: Evidence surrounding the impact of blood sterol lipid levels on ALS risk is inconsistent and low GRADE. Standardised methodologies and Lipidomics technologies are needed to confirm lipids as clinical biomarkers in ALS.

References:         1. Area-Gomez E, Larrea D, Yun T, Xu Y, Hupf J, Zandkarimi F, et al. Lipidomics study of plasma from patients suggest that ALS and PLS are part of a continuum of motor neuron disorders. Scientific reports. 2021;11(1):13562-.

Disclosure of Interest: None declared