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To the Editor:
Chio et al.1 found that the more severe the respiratory impairment, the lower the total cholesterol levels and lower the low-density lipoprotein (LDL)/high-density lipoprotein (HDL) ratio. They also suggested that increased energy demand or inflammatory status could be a cause of lipid status changes.
If body weight decreases, the lipid profile improves. In amyotrophic lateral sclerosis (ALS), weight loss occurs due to denervation-induced skeletal muscle atrophy. However, there may be another mechanism that promotes body weight loss and hypocholesterolemia.
When considering chronic obstructive pulmonary disease (COPD), there are interesting coincidences. Apart from lung dysfunction, COPD is considered a systemic inflammatory disease involving musculoskeletal, cardiovascular, endocrine systems, and metabolic changes leading to weight loss. The detailed mechanisms of weight loss are unknown, but the involvement of tumor necrosis factor–α (TNFα), interleukin-6, and other inflammatory cytokines have been reported.2
Alternatively, patients with ALS have higher serum inflammatory markers.3 In addition to respiratory …
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