Type 2 diabetes, obesity, and risk of amyotrophic lateral sclerosis: A population‐based cohort study

Author:

Skajaa Nils1ORCID,Riahi Emil Bjerregaard1,Szépligeti Szimonetta Komjáthiné1,Horváth‐Puhó Erzsébet1,Sørensen Trine Toft2,Henderson Victor W.134,Sørensen Henrik Toft15

Affiliation:

1. Department of Clinical Epidemiology Aarhus University Hospital and Aarhus University Aarhus Denmark

2. Institute of Public Health University of Copenhagen Copenhagen Denmark

3. Department of Epidemiology and Population Health Stanford University Stanford California

4. Department of Neurology and Neurological Sciences Stanford University Stanford California

5. Clinical Excellence Research Center Stanford University Stanford California

Abstract

AbstractBackgroundType 2 diabetes and obesity may be inversely associated with amyotrophic lateral sclerosis (ALS), but the evidence is controversial.MethodsUsing 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.ResultsWe 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).ConclusionsDiagnoses 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.

Publisher

Wiley

Subject

Behavioral Neuroscience

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