When analyzing the ALS patients in Clusters 3, 4, and 5, we observed the following: (i) the levels of MIP-1α, TTV, and, to a lesser degree, benzoic acid, were similar across these clusters, all showing a markedly distinct pattern from that of Cluster 1; (ii) Cluster 3 stood out for the lower expression of valeric and 2-ethilhexanoic acids (iii) Cluster 4 exhibited higher levels of hexadecanoic and octadecanoic acids; (iv) Cluster 5 was characterized by increased levels of 2-ethylhexanoic acids and decreased levels of MCP-1 and, to a lesser extent, octadecanoic acid and MIP1-α. Here, EXT1 is linked to amyotrophic lateral sclerosis.