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- Longinetti, E., et al.
(författare)
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Physical and cognitive fitness in young adulthood and risk of amyotrophic lateral sclerosis at an early age
- 2017
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Ingår i: European Journal of Neurology. - Stockholm : Wiley-Blackwell. - 1351-5101 .- 1468-1331. ; 24:1, s. 137-142
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: There is a clinical impression that patients with amyotrophic lateral sclerosis (ALS) have a higher level of physical fitness and lower body mass index (BMI) than average. However, there is a lack of literature examining the relationship between cognitive fitness and ALS risk. In this study we explored the associations of both physical and cognitive fitness with future risk of ALS.Methods: Data on physical fitness, BMI, intelligence quotient (IQ) and stress resilience were collected from 1 838 376 Swedish men aged 17-20 years at conscription during 1968-2010. Their subsequent ALS diagnoses were identified through the Swedish Patient Register. Hazard ratios (HRs) and 95% CIs from flexible parametric models were used to assess age-specific associations of physical fitness, BMI, IQ and stress resilience with ALS.Results: We identified 439 incident ALS cases during follow-up (mean age at diagnosis: 48 years). Individuals with physical fitness above the highest tertile tended to have a higher risk of ALS before the age of 45 years (range of HRs: 1.42-1.75; statistically significant associations at age 41-43 years) compared with others. Individuals with BMI ≥ 25 tended to have a lower risk of ALS at all ages (range of HRs: 0.42-0.80; statistically significant associations at age 42-48 years) compared with those with BMI < 25. Individuals with IQ above the highest tertile had a statistically significantly increased risk of ALS at an age of 56 years and above (range of HRs: 1.33-1.81), whereas individuals with stress resilience above the highest tertile had a lower risk of ALS at an age of 55 years and below (range of HRs: 0.47-0.73).Conclusions: Physical fitness, BMI, IQ and stress resilience in young adulthood might be associated with the development of ALS at an early age.
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| 2. |
- Kang, Xiaoying, et al.
(författare)
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Clostridium difficile infection and risk of Parkinson's disease : A Swedish population-based cohort study
- 2020
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Ingår i: European Journal of Neurology. - : Blackwell Publishing. - 1351-5101 .- 1468-1331. ; 27:11, s. 2134-2141
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gastrointestinal inflammation has been implicated in Parkinson's disease (PD). This study examined whether individuals with a history of Clostridium difficile infection (CDI) are at elevated risk of PD.METHODS: We performed a population-based cohort study using Swedish national register data. Adults aged ≥ 35 years were identified from the Swedish Population and Housing Census 1990 and followed during 1997-2013. Diagnoses of CDI and PD were extracted from the National Patient Register. Associations of CDI history with PD risk were estimated using Cox proportional hazards regression. We also explored whether the association differed by the source of CDI diagnosis (inpatient vs outpatient), presence of recurrent infections, and pre-infection use of antibiotics.RESULTS: Amongst the study population (N = 4,670,423), 34,868 (0.75%) had a history of CDI. A total of 165 and 47,035 incident PD cases were identified from individuals with and without CDI history, respectively. Across the entire follow-up, a 16% elevation of PD risk was observed among CDI group (hazard ratio: 1.16, 95% confidence interval: 1.00-1.36), which was mainly driven by increased PD risk within the first 2 years since CDI diagnosis (hazard ratio: 1.38, 95% confidence interval: 1.12-1.69). In longer follow-up, CDI was not associated with subsequent PD occurrence. This temporal pattern of CDI-PD associations was generally observed across all CDI subgroups.CONCLUSIONS: CDI may be associated with an increased short-term PD risk, but this might be explained by reverse causation and/or surveillance bias. Our results do not imply that CDI history affects long-term PD risk.
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| 3. |
- Mariosa, Daniela, et al.
(författare)
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Antidiabetics, Statins, and the Risk of Amyotrophic Lateral Sclerosis
- 2020
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Ingår i: European Journal of Neurology. - : Blackwell Publishing. - 1351-5101 .- 1468-1331. ; 27:6, s. 1010-1016
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Medications that are used for treatment of metabolic disorders have been suggested to be associated with the development of amyotrophic lateral sclerosis (ALS).METHODS: To examine the associations of antidiabetics and statins with the subsequent risk of ALS we conducted a population-based nested case-control study of 2,475 Swedish residents diagnosed with ALS during July 2006-December 2013, and 12,375 population controls (five for each ALS case). We extracted from the Swedish Prescribed Drug Register information on filled prescriptions of antidiabetics and statins for both cases and controls during the years before ALS diagnosis. Conditional logistic regression was used to calculate odds ratios (ORs) for the associations of these medications with ALS risk.RESULTS: ALS patients were less likely to have been prescribed with antidiabetics, compared to controls (OR=0.76, 95%CI=0.65-0.90). Conversely, statins were not associated with ALS risk overall (OR=1.08, 95%CI=0.98-1.19), although a positive association was noted among women (OR=1.28, 95%CI=1.10-1.48). The latter association was mostly explained by ALS cases being more likely to have a first prescription of statins during the year before diagnosis, compared to controls (OR=2.54, 95%CI=1.84-3.49).CONCLUSIONS: The inverse association of antidiabetics with ALS is consistent with the previously reported inverse association between type 2 diabetes and ALS risk. The increase in prescription of statins during the year before ALS diagnosis deserves attention because it might reflect an acceleration of the course of ALS due to statin use.
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| 4. |
- Sun, Jiangwei, et al.
(författare)
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Antibiotics Use and Risk of Amyotrophic Lateral Sclerosis in Sweden
- 2019
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Ingår i: European Journal of Neurology. - : Blackwell Publishing. - 1351-5101 .- 1468-1331. ; 26:11, s. 1355-1361
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Previous animal studies have suggested disrupted intestinal microbiome in amyotrophic lateral sclerosis (ALS). Due to the known effect of antibiotics on gut microflora, the potential role of antibiotics use on the risk of ALS deserves an investigation.METHODS: A nested case-control study was conducted using several Swedish national registers. We included 2,484 ALS patients diagnosed between July 1, 2006 and December 31, 2013 as cases and randomly selected five controls per case who were individually matched to the case by sex, birth year, and area of residence from the general Swedish population. Information on antibiotics prescriptions before ALS diagnosis was extracted from the Prescribed Drug Register for both cases and controls. Conditional logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: After accounting for potential diagnostic delay in ALS by excluding all prescriptions within one year before diagnosis, any antibiotics use was associated with a higher risk of ALS. The ORs (95% CIs) were 1.06 (0.94-1.19), 1.13 (1.00-1.28), and 1.18 (1.03-1.35) when comparing one, 2-3, and ≥4 prescriptions to no prescription (P for trend = 0.0069). Similar results were noted for antibiotics used for respiratory infections and urinary tract as well as skin and soft tissue infections. Among different individual antibiotics, the risk of ALS was especially increased in relation to more than two prescriptions of beta-lactamase sensitive penicillin (OR=1.28; 95% CI 1.10-1.50).CONCLUSIONS: Use of antibiotics, especially repeated, might be associated with a higher subsequent risk of ALS.
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