Environmental risk factors and amyotrophic lateral sclerosis (ALS): A case-control study of ALS in China

Lian, Ling; Liu, Mingsheng; Guan, Yuzhou; Liu, Tanxin; Cui, Bo; Zhang, Kang; Tai, Hongfei; Shen, Dongchao

doi:10.1016/j.jocn.2019.05.036

Cited by 43 publications

(54 citation statements)

References 43 publications

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“…As regards alcohol intake, although our results indicated an inverse association between wine or alcohol consumption and ALS, consistent with other reports [25,42,43], null [44] and positive associations [26,45] have also been described. In addition, considering the adverse effects of alcohol, we carried out an analysis using recommended alcohol units as cutoff points.…”

Section: Discussionsupporting

confidence: 93%

“…The positive association we found between ALS and smoking habits is consistent with previous studies [42,[45][46][47][48][49][50][51][52][53]. Despite a few studies reporting no difference or a decreasing risk in association with smoking [43,54,55], nevertheless, a detrimental effect of smoking has also been reported as a negative prognostic factor [56,57].…”

Section: Discussionsupporting

confidence: 92%

“…Nonetheless, this was statistically very imprecise and weak, based as it was on two exposed subjects only, suggesting extreme caution in the interpretation of these results. Most studies evaluating overall and individual sport playing generally showed an increased risk [43,53,75,77,83,[102][103][104][105][106][107], although different results have also been reported [42,54,94,[108][109][110]. Remarkably, our results showed an increased risk for skiers, consistent with recent findings about Swiss competitive players [111].…”

Section: Discussionsupporting

confidence: 90%

“…The hypothesis that trauma increases ALS risk has been suggested by several studies [43,[69][70][71][72][73][74], with specific reference to head trauma [42,[75][76][77][78][79][80], and column and trunk trauma [81,82]. However, inconsistent results have been reported by other studies [83][84][85][86].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

Filippini

Fiore

Tesauro

et al. 2020

IJERPH

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Background: Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disease of the motor neurons. The etiology of ALS remains largely unknown, particularly with reference to the potential environmental determinants. Methods: We performed a population-based case-control study in four provinces from both Northern and Southern Italy in order to assess non-genetic ALS risk factors by collecting through tailored questionnaires information about clinical and lifestyle factors. We estimated ALS risk by calculating odds ratio (OR) with its 95% confidence interval (CI) using unconditional logistic regression models adjusted for sex, age and educational attainment. Results: We recruited 230 participants (95 cases and 135 controls). We found a possible positive association of ALS risk with trauma, particularly head trauma (OR = 2.61, 95% CI 1.19–5.72), electric shock (OR = 2.09, 95% CI 0.62–7.06), and some sports, although at a competitive level only. In addition, our results suggest an increased risk for subjects reporting use of private wells for drinking water (OR = 1.38, 95% CI 0.73–2.27) and for use of herbicides during gardening (OR = 1.95, 95% CI 0.88–2.27). Conversely, there was a suggestion of an inverse association with overall fish consumption (OR = 0.27, 95% CI 0.12–0.60), but with no dose-response relation. Consumption of some dietary supplements, namely those containing amino acids and, in the Southern Italy population, vitamins and minerals such as selenium, seemed associated with a statistically imprecise increased risk. Conclusions: Our results suggest a potential etiologic role a number of clinical and lifestyle factors with ALS risk. However, caution is needed due to some study limitations. These include the small sample size and the low number of exposed subjects, which affect statistical precision of risk estimates, the potential for exposure misclassification, and the uncertainties about mechanisms underpinning the possible association between these factors and disease risk.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

Filippini

Fiore

Tesauro

et al. 2020

IJERPH

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“…4 Environmental factors have also been implicated in ALS pathogenesis. 5 Although exposure to individual environmental factors is weakly causal, cumulative exposure is likely to exceed the disease-onset threshold leading to development of ALS. 6 Separately, epigenetic modifications are increasingly recognized as an important mechanism in ALS pathogenesis, 7 potentially providing a link between genetic predisposition and cumulative environmental exposure.…”

mentioning

confidence: 99%

ALS is a multistep process in South Korean, Japanese, and Australian patients

Vucic¹,

Higashihara²,

Sobue³

et al. 2020

Neurology

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ObjectiveTo establish whether amyotrophic lateral sclerosis (ALS) is a multistep process in South Korean and Japanese populations when compared to Australian cohorts.MethodsWe generated incident data by age and sex for Japanese (collected between April 2009 and March 2010) and South Korean patients with ALS (collected between January 2011 and December 2015). Mortality rates were provided for Australian patients with ALS (collected between 2007 and 2016). We regressed the log of age-specific incidence against the log of age with least squares regression for each ALS population.ResultsWe identified 11,834 cases of ALS from the 3 populations, including 6,524 Australian, 2,264 Japanese, and 3,049 South Korean ALS cases. We established a linear relation between the log incidence and log age in the 3 populations: Australia r2 = 0.99, Japan r2 = 0.99, South Korea r2 = 0.99. The estimate slopes were similar across the 3 populations, being 5.4 (95% confidence interval [CI], 4.8–5.5) in Japanese, 5.4 (95% CI, 5.2–5.7) in Australian, and 4.4 (95% CI, 4.2–4.8) in South Korean patients.ConclusionsThe linear relationship between log age and log incidence is consistent with a multistage model of disease, with slope estimated suggesting that 6 steps were required in Japanese and Australian patients with ALS while 5 steps were needed in South Korean patients. Identification of these steps could identify novel therapeutic strategies.

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Education, intelligence, and amyotrophic lateral sclerosis: A Mendelian randomization study

Zhang

Tang

Xia

et al. 2020

Ann Clin Transl Neurol

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Objective To systematically investigate causal relationships between educational attainment, cognitive‐related phenotypes, and amyotrophic lateral sclerosis (ALS). Methods Summary statistics from genome‐wide association studies for educational attainment, math ability, highest math class taken, cognitive performance, intelligence, and ALS were used. A two‐sample Mendelian randomization (MR) design was applied to explore the potential causal associations between them. Results Genetically predisposition to longer educational attainment and harder math class taken were associated with significantly lower statistical odds ratio of ALS. For per year increase in education completed there was a 21% lower (95% confidence interval [CI] = 27–14%) in risk for ALS. For per 1‐SD increase in the highest math class taken obtained there was a 19% lower (95% CI = 9–28%) in risk for ALS. Genetically predisposition to math ability, cognitive performance, and intelligence did not decrease the risk of ALS. Interpretation This study provides genetic support for a causal association between higher educational attainment and a lower risk of ALS. The genes related to these phenotypes are involved in almost all aspects of neuron‐to‐neuron communication. ALS patients are occasionally accompanied by varying degrees of cognitive impairment. People with greater cognitive reserve may be better able to offset damages of degenerative brain changes associated with dementia or other brain diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, or ALS.

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Environmental risk factors and amyotrophic lateral sclerosis (ALS): A case-control study of ALS in China

Cited by 43 publications

References 43 publications

Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

ALS is a multistep process in South Korean, Japanese, and Australian patients

Education, intelligence, and amyotrophic lateral sclerosis: A Mendelian randomization study

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