Abstract
Background
Type 2 diabetes and obesity may be inversely associated with amyotrophic lateral sclerosis (ALS), but the evidence is controversial.
Methods
Using Danish, nationwide registries (1980-2016), we identified patients with a diagnosis of type 2 diabetes (N = 295,653) and patients with a diagnosis of obesity (N = 312,108). Patients were matched (1:3) to persons from the general population on birth year and sex. We computed incidence rates and Cox regression derived hazard ratios (HRs) of a diagnosis of ALS. In multivariable analyses, HRs were controlled for sex, birth year, calendar year, and comorbidities.
Results
We observed 168 incident cases of ALS (0.7 [95% confidence interval (CI): 0.6–0.8] per 10,000 person-years) among patients with type 2 diabetes and 859 incident cases of ALS (0.9 [95% CI: 0.9–1.0] per 10,000 person-years) among matched comparators. The adjusted HR was 0.87 (95% CI: 0.72–1.04). The association was present among men (adjusted HR: 0.78 [95% CI: 0.62–0.99]) but not women (adjusted HR: 1.03 [95% CI: 0.78–1.37]), and among those aged ≥60 years (adjusted HR: 0.75 [95% CI: 0.59–0.96]) but not younger. We observed 111 ALS events (0.4 [95% CI: 0.4–0.5] per 10,000 person-years) among obesity patients and 431 ALS events (0.5 [95% CI: 0.5–0.6] per 10,000 person-years) among comparators. The adjusted HR was 0.88 (95% CI: 0.70–1.11).
Conclusions
Diagnoses of type 2 diabetes and obesity were associated with a reduced rate of ALS compared with general population comparators, particularly among men and patients aged 60 years or above. However, absolute rate differences were small.
Type 2 diabetes and obesity may be inversely associated with amyotrophic lateral sclerosis (ALS), but the evidence is controversial.
Methods
Using Danish, nationwide registries (1980-2016), we identified patients with a diagnosis of type 2 diabetes (N = 295,653) and patients with a diagnosis of obesity (N = 312,108). Patients were matched (1:3) to persons from the general population on birth year and sex. We computed incidence rates and Cox regression derived hazard ratios (HRs) of a diagnosis of ALS. In multivariable analyses, HRs were controlled for sex, birth year, calendar year, and comorbidities.
Results
We observed 168 incident cases of ALS (0.7 [95% confidence interval (CI): 0.6–0.8] per 10,000 person-years) among patients with type 2 diabetes and 859 incident cases of ALS (0.9 [95% CI: 0.9–1.0] per 10,000 person-years) among matched comparators. The adjusted HR was 0.87 (95% CI: 0.72–1.04). The association was present among men (adjusted HR: 0.78 [95% CI: 0.62–0.99]) but not women (adjusted HR: 1.03 [95% CI: 0.78–1.37]), and among those aged ≥60 years (adjusted HR: 0.75 [95% CI: 0.59–0.96]) but not younger. We observed 111 ALS events (0.4 [95% CI: 0.4–0.5] per 10,000 person-years) among obesity patients and 431 ALS events (0.5 [95% CI: 0.5–0.6] per 10,000 person-years) among comparators. The adjusted HR was 0.88 (95% CI: 0.70–1.11).
Conclusions
Diagnoses of type 2 diabetes and obesity were associated with a reduced rate of ALS compared with general population comparators, particularly among men and patients aged 60 years or above. However, absolute rate differences were small.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | e3007 |
| Tidsskrift | Brain and Behavior |
| Vol/bind | 13 |
| Udgave nummer | 6 |
| Antal sider | 10 |
| ISSN | 2157-9032 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Publisher Copyright:© 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.