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Malnutrition Risk in Huntington’s Disease: A Cohort Study on Prevalence and Prognosis with Mendelian Randomization Validation

YF. Cheng, HF. Shang (Chengdu, Sichuan, China)

Meeting: 2025 International Congress

Keywords: Chorea (also see specific diagnoses, Huntingtons disease, etc): Clinical features

Category: Huntington's Disease

Objective: This study aimed to investigate malnutrition prevalence (using the Controlling Nutritional Status Score [CONUT], Prognostic Nutritional Index [PNI], and Geriatric Nutritional Risk Index [GNRI]), clinical correlations, and the prognostic value of malnutrition in patients with HD.

Background: Malnutrition is prevalent in neurodegenerative diseases while its prevalence and prognostic significance remain unclear in Chinese patients with Huntington’s disease (HD).

Method: The 113 genetically confirmed HD patients and age, sex matched healthy controls (HCs) were recruited. Malnutrition risk and the correlation between malnutrition and follow-up outcomes was analyzed. Two-sample mendelian randomization (MR) was conducted to infer the causal relationship between nutritional assessment and HD progression.

Results: HD patients exhibited a higher prevalence of malnutrition than HCs via CONUT and GNRI. GNRI scores inversely correlated with UHDRS-I (r=-0.253, p=0.044) and disease stage (r=-0.319, p=0.009), while positively correlated with UHDRS-IV (r= 0.305, p=0.014) and cUHDRS (r= 0.321, p=0.034). Multivariate models adjusting for age, sex, and CAG repeat numbers,  showed that malnutrition by GNRI predicted lower TFC score (β=0.47, p=0.050), advanced disease stage (β= -2.38, p=0.012), lower SDMT score (β=0.17, p=0.039), and lower cUHDRS score (β=0.612, p=0.011). Lower cUHDRS scores (β=0.325, p=0.047) were associated with malnutrition by PNI in HD patients. Survival analysis showed no independent prognostic impact of malnutrition with the median survival time of 13.87 years, yet MR indicated higher lymphocyte count in delaying HD age to reach TMS30 (β=0.125, 95% CI 0.023-0.228; p=0.017).

Conclusion: While malnutrition is prevalent in HD and associated with functional and cognitive deficits, it lacks independent prognostic value. MR findings suggest that immune-nutritional interactions may influence HD progression timing.

To cite this abstract in AMA style:

YF. Cheng, HF. Shang. Malnutrition Risk in Huntington’s Disease: A Cohort Study on Prevalence and Prognosis with Mendelian Randomization Validation [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/malnutrition-risk-in-huntingtons-disease-a-cohort-study-on-prevalence-and-prognosis-with-mendelian-randomization-validation/. Accessed October 5, 2025.
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