Authors: Meinie Seelen Perry T C van Doormaal Anne E Visser Mark H B Huisman Margot H J Roozekrans Sonja W de Jong Anneke J van der Kooi Marianne de Visser Nicol C Voermans Jan H Veldink Leonard H van den Berg
Publish Date: 2014/07/25
Volume: 261, Issue: 10, Pages: 1949-1956
Abstract
Sporadic amyotrophic lateral sclerosis ALS is believed to be a complex disease in which multiple exogenous and genetic factors interact to cause motor neuron degeneration Elucidating the association between medical conditions prior to the first symptoms of ALS could lend support to the theory that specific subpopulations are at risk of developing ALS and provide new insight into shared pathogenic mechanisms We performed a populationbased case–control study in the Netherlands including 722 sporadic ALS patients and 2268 age and gender matched controls Data on medical conditions and use of medication were obtained through a structured questionnaire Multivariate analyses showed that hypercholesterolemia OR 076 95 CI 063–092 P = 0006 the use of statins OR 045 95 CI 035–059 P = 186 × 10−9 or immunosuppressive drugs OR 026 95 CI 008–086 P = 003 were associated with a decreased risk of ALS Head trauma was associated with an increased ALS susceptibility OR 195 95 CI 111–343 P = 002 No association was found with autoimmune diseases cancer psychiatric disorders or cardiovascular diseases or survival The lower frequency of hypercholesterolemia and less use of statins in ALS patients indicate a favorable lipid profile prior to symptom onset in at least a subpopulation of ALS Prior head trauma is a risk factor for ALS and the significantly lower use of immunosuppressive drugs in ALS patients could suggest a protective effect The identification of specific subpopulations at risk for ALS may provide clues towards possible pathogenic mechanismsThe authors thank Hermieneke Vergunst University Medical Center Utrecht for technical assistance This work was supported by the Prinses Beatrix Spierfonds PB 0703 VSB fonds H Kersten and M Kersten Kersten Foundation The Netherlands ALS Foundation JR van Dijk and the Adessium Foundation Netherlands Organisation for Health Research and Development Vici scheme to LHvdB and the European Community’s Health Seventh Framework Programme FP7/2007–2013 Grant Agreement No 259867 Sponsors of the study had no role in study design data collection data analysis data interpretation or writing of the report
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