背景:这项研究是对瑞典ALSrisc研究的介绍,并探讨了生活方式与医疗状况的关联,与肌萎缩侧索硬化症(ALS)的风险和进展。
方法:我们纳入了2016-2022年在斯德哥尔摩的265例新诊断的ALS患者和207例无ALS的兄弟姐妹和伴侣作为对照。关于体重指数(BMI)的信息,吸烟,和头部受伤史,糖尿病,高胆固醇血症,在招募时通过Euro-MOTOR问卷获得高血压.患者从诊断到死亡,有创通气,或2022年11月30日。
结果:招募时较高的BMI与较低的ALS风险相关(OR0.89,95CI0.83-0.95),尤其是在65岁后确诊的患者中。诊断前30年平均BMI增加1个单位与ALS风险降低相关(OR0.94,95CI0.89-0.99)。糖尿病与较低的ALS风险相关(OR0.38,95CI0.16-0.90),而高胆固醇血症与较高的ALS风险相关(OR2.10,95CI1.13-3.90)。诊断时较高的BMI与较低的死亡风险相关(HR0.91,95CI0.84-0.98),而吸烟暴露水平最高(以包年为单位)(HR1.90,95CI1.20-3.00),高胆固醇血症(HR1.84,95CI1.06-3.19),高血压(HR1.76,95CI1.03-3.01)与较高的死亡风险相关,ALS诊断后。
结论:较高的BMI和糖尿病与较低的ALS风险相关。较高的BMI与较低的死亡风险相关,而吸烟(尤其是在高包装年),高胆固醇血症,和高血压与ALS诊断后较高的死亡风险相关。
BACKGROUND: This study was an introduction to the Swedish ALSrisc Study and explored the association of lifestyle and medical conditions, with risk and progression of amyotrophic lateral sclerosis (ALS).
METHODS: We included 265 newly diagnosed ALS patients during 2016-2022 in Stockholm and 207 ALS-free siblings and partners of the patients as controls. Information on body mass index (BMI), smoking, and history of head injuries, diabetes mellitus, hypercholesterolemia, and hypertension was obtained through the Euro-MOTOR questionnaire at recruitment. Patients were followed from diagnosis until death, invasive ventilation, or November 30, 2022.
RESULTS: Higher BMI at recruitment was associated with lower risk for ALS (OR 0.89, 95%CI 0.83-0.95), especially among those diagnosed after 65 years. One unit increase in the average BMI during the 3 decades before diagnosis was associated with a lower risk for ALS (OR 0.94, 95%CI 0.89-0.99). Diabetes was associated with lower risk of ALS (OR 0.38, 95%CI 0.16-0.90), while hypercholesterolemia was associated with higher risk of ALS (OR 2.10, 95%CI 1.13-3.90). Higher BMI at diagnosis was associated with lower risk of death (HR 0.91, 95%CI 0.84-0.98), while the highest level of smoking exposure (in pack-years) (HR 1.90, 95%CI 1.20-3.00), hypercholesterolemia (HR 1.84, 95%CI 1.06-3.19), and hypertension (HR 1.76, 95%CI 1.03-3.01) were associated with higher risk of death, following ALS diagnosis.
CONCLUSIONS: Higher BMI and diabetes were associated with lower risk of ALS. Higher BMI was associated with lower risk of death, whereas smoking (especially in high pack-years), hypercholesterolemia, and hypertension were associated with higher risk of death after ALS diagnosis.