Association of copper status with lipid profile and functional status in patients with amyotrophic lateral sclerosis.
Amyotrophic lateral sclerosis, copper, lipid profile.
The lateral amyotrophic sclerosis (ALS) is a progressive and fatal neurodegenerative disease of unknown etiology, characterized by the motor neuron degeneration, muscle paralysis and death. Oxidative stress is one of the main mechanisms associated with the pathogenesis of amyotrophic lateral sclerosis (ALS). Copper is a mineral capable of influencing cellular oxidation and lipid profile. The aim of this study was to evaluate the association of copper status with lipid profile and functional status in patients with ALS. A cross-sectional study was carried out including 27 patients with ALS (case group) and 26 healthy individuals (control group). Copper status was evaluated by habitual dietary copper intake, plasma copper and serum ceruloplasmin concentrations. The lipid profile included analysis of serum total cholesterol (TC), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), and triglycerides (TGL). The functional status of patients with ALS was assessed by the revised ALS functional rating scale (ALSFRS-R). Student's t-test and Mann Whitney's test were used for comparison of means. Correlation between plasma copper and biochemical and dietary markers was made by Spearman's correlation test. The effect of the independent variables on the functional scale was estimated by model based on Poisson distribution. The level of significance adopted was 5%. The case group had lower concentrations of plasma copper compared with the control group (133.9 vs. 164.1 µg/dL, p=0.0001). Also, in the case group, plasma copper was positively correlated with HDL-c (rs=0.398, p=0.044). However, in the control group, plasma copper was positively correlated with serum ceruloplasmin (rs=0.646, p<0.001), TC (rs=0.446, p=0.025), LDL-c (rs=0.445, p=0.029) and HDL-c (rs=0.479, p=0.015). Only in the control group ceruloplasmin was positively correlated with LDL-c (rs=0.407, p=0.043). In the case group, dietary copper intake (B=-0.373, p<0.001), plasma copper (B=-0.005, p=0.033) and TC (B=-0.312; p=0.001) were inversely associated with the functional status of patients with ALS. In contrast, serum ceruloplasmin (B=0.016, p=0.044), LDL-c (B=0.314, p=0.001), HDL-c (B=0.308, p=0.001) and TGL (B=0.062; p=0.001) were positively associated with their functional status. In conclusion, this study suggests a disturbance of copper status and its connection with the lipid profile in patients with ALS. Furthermore, copper status and lipid profile may influence the functional status of patients with ALS, standing out as potential biomarkers to evaluate the severity of the disease.