[Evaluation value of NRS2002 and MNA-SF on nutritional status and prognosis in adult patients with amyotrophic lateral sclerosis].

Authors

Y W Liu, D S Fan, L Chen

Published in

Zhonghua yi xue za zhi. Volume 106. Issue 35. Pages 3746-3753. Sep 22, 2026.

Abstract

Objective: To evaluate the value of the Nutritional Risk Screening 2002 (NRS2002) and the Mini-Nutritional Assessment Short-Form (MNA-SF) in assessing nutritional status, disease progression, and prognosis in adult patients with amyotrophic lateral sclerosis (ALS). Methods: Baseline data of 148 ALS patients who visited Peking University Third Hospital from January to December 2024 were prospectively collected. Patients were divided into malnutrition group and normal group based on the presence of nutritional risk. Assessments were conducted every 3 months over a 1-year follow-up period, during which ALSFRS-R scores, body mass index (BMI), and nutritional scale scores were recorded. The rates of ALSFRS-R score decline (δFS) and BMI change (δBMI) were calculated as (baseline ALSFRS-R score-follow-up ALSFRS-R score)/follow-up months and (baseline BMI-follow-up BMI)/follow-up months, respectively. The primary endpoint events were death or tracheostomy. Clinical data were compared between patients with different nutritional statuses. Spearman and Pearson correlation analyses were used to explore the correlations between scale scores and various indicators. Cohen's Kappa coefficient was used to evaluate the inter-rater consistency between the two scales. Linear mixed-effects models were applied to assess the relationships between nutritional risk and changes in δFS and δBMI. Results: A total of 148 ALS patients were collected in this study, including 96 males and 52 females, with the age [M(Q₁, Q₃)] of 56.0 (49.0, 61.0) years. A total of 4 enrolled patients were excluded from the NRS2002 assessment owing to missing BMI data, which resulted from the inability to measure height and weight in these bedridden individuals. Based on the NRS2002 and MNA-SF, patients were classified into the malnutrition group (NRS2002 malnutrition group, n=45; MNA-SF malnutrition group, n=59) and the normal group (NRS2002 normal group, n=99; MNA-SF normal group, n=89). The Kappa values for the consistency between NRS2002 and MNA-SF at baseline, 3, 6, 9, and 12 months were 0.726, 0.713, 0.698, 0.648, and 0.769, respectively (all P<0.001). NRS2002 was negatively correlated with BMI (r=-0.413, P<0.001), body weight (r=-0.442, P<0.001), prealbumin (r=-0.253, P<0.001), creatinine (r=-0.139, P=0.049), and triglycerides (r=-0.228, P=0.003); MNA-SF was positively correlated with BMI (r=0.573, P<0.001), body weight (r=0.514, P<0.001), prealbumin (r=0.277, P<0.001), creatinine (r=0.233, P=0.002), and triglycerides (r=0.289, P<0.001). After adjusting for confounders using linear mixed-effects models, a higher NRS2002 score was identified as a risk factor for increases in δFS (β = 0.127, 95%CI: 0.065-0.189, P<0.001) and δBMI (β=0.150, 95%CI: 0.104-0.197, P<0.001), whereas a higher MNA-SF score served as a protective factor against increases in δFS (β=-0.090, 95%CI:-0.116 to -0.064, P<0.001) and δBMI (β=-0.092, 95%CI:-0.113 to -0.071, P<0.001). Conclusions: NRS2002 and MNA-SF demonstrate good consistency in nutritional risk assessment among ALS patients. The scores of both scales are correlated with traditional nutritional indicators including BMI, body weight, prealbumin, creatinine, and triglycerides, and are associated with the rates of ALSFRS-R and BMI changes in these patients.

PMID:
42763209
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

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