Anders Myhre Vaage, Jūratė Šaltytė Benth, Haakon E Meyer, Trygve Holmøy, Ola Nakken
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Mean follow-up time was 23.7 (SD 7.1) years among ALS cases. One mmol/l increase in LDL-C was associated with 6% increase in risk for ALS (hazard ratio 1.06 [95% CI: 1.01-1.09]). Higher levels of TC and TG were also associated with increased ALS risk, but only within the last 6-7 years prior to ALS diagnosis or death. No association between HDL-C and ALS risk was found. Adjusting for body mass index, birth cohort, smoking, and physical activity did not alter the results.</p><p><strong>Conclusions: </strong>Higher levels of LDL-C are associated with increased ALS risk over 40 years later, compatible with a causal relationship. 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引用次数: 0
摘要
目的评估病前血脂水平与长期肌萎缩侧索硬化症(ALS)风险之间的时间关系:我们从挪威心血管健康调查(1974-2003年)中收集了总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、葡萄糖和其他心血管风险因素的信息。ALS的发病率和死亡率是通过有效的挪威健康登记确定的。通过 Cox 回归模型评估了病前血脂水平与 ALS 风险之间的关系:在640,066名研究参与者(51.5%为女性)中,有974人(43.5%为女性)罹患ALS。ALS病例的平均随访时间为23.7年(标准偏差为7.1年)。低密度脂蛋白胆固醇(LDL-C)每增加 1 毫摩尔/升,ALS 的患病风险就会增加 6%(危险比 1.06 [95% CI:1.01-1.09])。较高水平的总胆固醇和总胆固醇也与 ALS 风险增加有关,但仅发生在 ALS 诊断或死亡前的 6-7 年内。高密度脂蛋白胆固醇与 ALS 风险之间没有关联。调整体重指数、出生队列、吸烟和体育锻炼并没有改变结果:结论:较高水平的低密度脂蛋白胆固醇与 40 年后 ALS 风险的增加有关,两者之间存在因果关系。TG、TC 和 ALS 风险之间的时间关系表明,这些血脂生物标志物水平的升高代表了 ALS 的后果。
Premorbid lipid levels and long-term risk of ALS-a population-based cohort study.
Objective: To assess the temporal relationship between premorbid lipid levels and long-term amyotrophic lateral sclerosis (ALS) risk.
Methods: From Norwegian cardiovascular health surveys (1974-2003), we collected information on total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose, and other cardiovascular risk factors. ALS incidence and mortality were identified through validated Norwegian health registries. The relation between premorbid lipid levels and ALS risk was assessed by Cox regression models.
Results: Out of 640,066 study participants (51.5% females), 974 individuals (43.5% females) developed ALS. Mean follow-up time was 23.7 (SD 7.1) years among ALS cases. One mmol/l increase in LDL-C was associated with 6% increase in risk for ALS (hazard ratio 1.06 [95% CI: 1.01-1.09]). Higher levels of TC and TG were also associated with increased ALS risk, but only within the last 6-7 years prior to ALS diagnosis or death. No association between HDL-C and ALS risk was found. Adjusting for body mass index, birth cohort, smoking, and physical activity did not alter the results.
Conclusions: Higher levels of LDL-C are associated with increased ALS risk over 40 years later, compatible with a causal relationship. The temporal relationship between TG, TC, and ALS risk suggests that increased levels of these lipid biomarkers represent consequences of ALS.