ALS disease onset may occur later in patients with pre-morbid diabetes mellitus

作者:Jawaid A; Salamone A R; Strutt A M; Murthy S B; Wheaton M; McDowell E J; Simpson E; Appel S H; York M K; Schulz P E*
来源:European Journal of Neurology, 2010, 17(5): 733-739.
DOI:10.1111/j.1468-1331.2009.02923.x

摘要

Background
Several metabolic derangements associated with diabetes mellitus type 2 (DM) have been associated with a better outcome in amyotrophic lateral sclerosis (ALS), including hyperlipidemia and obesity. Here, we tested the hypothesis that DM would have a positive effect on the motor and cognitive findings of ALS.
Methods:
We compared data from ALS patients with pre-morbid DM (ALS-DM; n = 175) versus without DM (ALS; n = 2196) with regard to the age of onset, rate of motor progression, survival, and neuropsychological test performance.
Results:
The age of onset was later for women, Caucasians and patients with bulbar-onset ALS. However, we also found that after adjusting for gender, ethnicity and site of onset, DM was associated with a 4-year later onset of ALS (ALS = 56.3, ALS-DM = 60.3, P < 0.05).
Conclusion:
Diabetes mellitus type 2 may delay the onset of motor symptoms in ALS. These findings support other studies suggesting a relationship between the pathophysiology of ALS and metabolic derangements. Further investigations are needed to ascertain whether manipulating metabolic parameters would improve outcomes in ALS.

  • 出版日期2010-5