肌萎缩侧索硬化症（ALS）的发病可能会在有前驱糖尿病的患者中延迟。
ALS disease onset may occur later in patients with pre-morbid diabetes mellitus.
机构信息
Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
出版信息
Eur J Neurol. 2010 May;17(5):733-9. doi: 10.1111/j.1468-1331.2009.02923.x. Epub 2010 Jan 13.
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.
背景
几种与 2 型糖尿病（DM）相关的代谢紊乱与肌萎缩侧索硬化症（ALS）的预后较好有关，包括高血脂和肥胖。在这里，我们检验了这样一个假设，即糖尿病会对 ALS 的运动和认知表现产生积极影响。
方法
我们比较了有预发性糖尿病（ALS-DM；n = 175）和无糖尿病（ALS；n = 2196）的 ALS 患者的数据，比较的内容包括发病年龄、运动进展速度、生存率和神经心理学测试表现。
结果
女性、白种人和延髓起病的 ALS 患者的发病年龄较晚。然而，我们还发现，在调整性别、种族和发病部位后，DM 与 ALS 的发病时间晚 4 年有关（ALS = 56.3，ALS-DM = 60.3，P < 0.05）。
结论
2 型糖尿病可能会延迟 ALS 运动症状的发作。这些发现支持了其他研究表明 ALS 的病理生理学与代谢紊乱之间存在关系的观点。需要进一步的研究来确定是否可以通过改变代谢参数来改善 ALS 的预后。
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