【 論文名 】
Weight maintenance following enteral nutrition is associated with prolonged survival in amyotrophic lateral sclerosis
（筋萎縮性側索硬化症（ALS）における経腸栄養後の体重維持と生命予後との関連 ）

【 発表雑誌 】
Journal of Neurology
11 April 2026 : Volume 273, article number 267, (2026) .　https://doi.org/10.1007/s00415-026-13776-3

Springer Nature（外部リンク）
https://link.springer.com/article/10.1007/s00415-026-13776-3

Objective：To investigate the association between energy intake at the initiation of enteral nutrition (EN), subsequent changes in body mass index (BMI), and survival in patients with amyotrophic lateral sclerosis (ALS).

Methods：This retrospective study included 121 patients with ALS who received EN. Annual BMI decline rates (∆BMI, kg/m2/year) were calculated for three periods: from symptom onset to diagnosis (T1–T2), from diagnosis to EN initiation (T2–T3), and from EN initiation to post-EN assessment (T3–T4). Energy intake per weight (E/W, kcal/kg/day) at EN initiation was also assessed. Survival after EN initiation was analyzed using Kaplan–Meier methods and Cox proportional hazards models.

Results：Post-EN BMI decline (∆BMIT3–T4) showed a significant negative correlation with E/W at T3 (p < 0.001). Patients with lower post-EN BMI decline (∆BMI < 0.8 kg/m2/year) had significantly longer survival after EN initiation than those with greater BMI decline (p < 0.001). Multivariate Cox analysis identified ∆BMIT3–T4 and pre-EN respiratory decline as independent predictors of post-EN survival. Subgroup analyses demonstrated that patients who maintained body weight after EN had better survival irrespective of energy intake at EN initiation.

Conclusions：Weight maintenance following EN was associated with prolonged survival in ALS, whereas energy intake at EN initiation alone was not. These findings suggest that the survival benefit of nutritional intervention may be mediated through stabilization of body weight rather than caloric intake per se.

本研究は東京都立神経病院との共同研究により行われました。