de la Rubia Ortí, Jose EnriquePlatero Armero, Jose LuisSanchis-Sanchis, Claudia EmmanuelaSancho-Castillo, SandraSalazar, AlejandroCaplliure-Llopis, JordiNavarro-Illana, EstherBarrios, CarlosEscribá-Alepuz, JesúsBenlloch, María2022-12-142022-12-142021-04-09de la Rubia Ortí JE, Armero JLP, Sanchis-Sanchis CE, Sancho-Castillo S, Salazar A, Caplliure-Llopis J, et al. Muscle Function Differences between Patients with Bulbar and Spinal Onset Amyotrophic Lateral Sclerosis. Does It Depend on Peripheral Glucose? J Clin Med. 2021 Apr 9;10(8):1582http://hdl.handle.net/10668/4504Background: One of the pathogenic mechanisms of ALS disease is perturbed energy metabolism particularly glucose metabolism. Given the substantial difference in the severity and the prognosis of the disease, depending on whether it has a bulbar or spinal onset, the aim of the study was to determine metabolic differences between both types of ALS, as well as the possible relationship with muscle function. Materials and Methods: A descriptive, analytical, quantitative, and transversal study was carried out in hospitals and Primary Care centers in the region of Valencia, Spain. Fasting glucose and alkaline phosphatase (AP) levels in venous blood, muscle percentage, fat percentage, muscle strength (MRC scale), and functional capacity (Barthel Index) were measured in 31 patients diagnosed with ALS (20 with spinal onset ALS and 11 with bulbar onset ALS). A healthy control of 29 people was included. Results: No significant differences were observed in blood AP and glucose levels between spinal onset and bulbar onset ALS patients. However, a significant positive correlation was observed between the mean values of both substances in patients with spinal onset ALS. Moreover, a lower percentage of muscle mass and a higher percentage of fat mass were also seen in spinal ALS patients, who also presented lower muscle strength and lower functional capacity. Conclusion: The results of this study seem to point to a possible difference in the peripheral use of glucose between patients with bulbar onset ALS and spinal onset ALS, who appear to have possible insulin resistance. These metabolic differences could explain the lower muscle percentage and lower muscular function in spinal onset ALS patients, although further studies are required.enAtribución 4.0 InternacionalAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Amyotrophic lateral sclerosisGlucoseAlkaline phosphataseSpinal onset ALSBulbar onset ALSInsulin resistanceMuscle strengthEsclerosis amiotrófica lateralGlucosaFosfatasa alcalinaAtrofia muscular espinalEsclerosis amiotrófica lateralResistencia a la insulinaFuerza muscularMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Diseases::Nervous System Diseases::Neurodegenerative Diseases::Motor Neuron Disease::Amyotrophic Lateral SclerosisMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Esterases::Phosphoric Monoester Hydrolases::Alkaline PhosphataseMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior::FastingMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hyperinsulinism::Insulin ResistanceMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Anatomy::Musculoskeletal System::MusclesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Muscle StrengthMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::PrognosisMedical Subject Headings::Chemicals and Drugs::Carbohydrates::Monosaccharides::Hexoses::GlucoseMedical Subject Headings::Phenomena and Processes::Metabolic Phenomena::Metabolism::Energy MetabolismMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health CareMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitalsresearch article33918552Acceso abierto10.3390/jcm100815822077-0383PMC8069029