'Rita Levi Montalcini' Department of Neurosciences, University of Turin, Turin.
Epidemiology Department ASL TO3 - Piedmont Region, Grugliasco, Turin, Italy.
Eur J Neurol. 2018 Jan;25(1):164-170. doi: 10.1111/ene.13465. Epub 2017 Oct 21.
The literature on the association between diabetes and amyotrophic lateral sclerosis (ALS) consists of a limited number of studies. This cohort study was developed in order to assess the role of diabetes on the risk of developing ALS.
The study population was represented by all residents in Turin (Italy) at the beginning of 1996 who participated in the 1991 census, over 14 years of age (n = 727 977) and followed up for ALS occurrence from 1998 to 2014. Presence of diabetes at baseline or during follow-up was ascertained through two Piedmont regional sources: the Diabetes Registry and the Anatomical Therapeutic Chemical Drug Prescription Archive. The risk of ALS was estimated using the Piedmont and Valle d'Aosta ALS Registry (PARALS). The association of diabetes, treated as a time-dependent variable, with ALS onset was estimated through Cox proportional hazard regression models adjusted for age, gender, education and marital status.
During follow-up, 397 subjects developed ALS, 24 of whom were already diabetic before ALS onset. Diabetes was associated with a significantly decreased risk of ALS [hazard ratio, 0.30 (95% confidence interval, 0.19-0.45)] without differences in risk by gender, age class or ALS phenotype.
The results support the protective role of diabetes toward ALS.
关于糖尿病与肌萎缩侧索硬化症（ALS）之间关联的文献研究数量有限。本队列研究旨在评估糖尿病对发生 ALS 风险的作用。
研究人群为 1996 年初居住在都灵（意大利）的所有居民，他们参加了 1991 年的人口普查，年龄在 14 岁以上（n=727977），并在 1998 年至 2014 年期间对 ALS 的发病情况进行了随访。通过两个皮埃蒙特地区的来源确定基线或随访期间是否存在糖尿病：糖尿病登记处和解剖治疗化学药物处方档案。使用皮埃蒙特和瓦莱达奥斯塔 ALS 登记处（PARALS）来评估 ALS 的风险。通过 Cox 比例风险回归模型，将糖尿病作为时间依赖性变量，调整年龄、性别、教育程度和婚姻状况后，对其与 ALS 发病的相关性进行了估计。
在随访期间，有 397 名患者发生了 ALS，其中 24 名在 ALS 发病前已经患有糖尿病。糖尿病与 ALS 发病风险显著降低相关[风险比，0.30（95%置信区间，0.19-0.45)]，但与性别、年龄组或 ALS 表型无关。
结果支持糖尿病对 ALS 的保护作用。
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