Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy.
Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy.
Biomolecules. 2021 Jun 10;11(6):867. doi: 10.3390/biom11060867.
Amyotrophic Lateral Sclerosis (ALS) is a degenerative disorder which affects the motor neurons. Growing evidence suggests that ALS may impact the metabolic system, including the glucose metabolism. Several studies investigated the role of Diabetes Mellitus (DM) as risk and/or prognostic factor. However, a clear correlation between DM and ALS has not been defined. In this review, we focus on the role of DM in ALS, examining the different hypotheses on how perturbations of glucose metabolism may interact with the pathophysiology and the course of ALS.
We undertook an independent PubMed literature search, using the following search terms: ((ALS) OR (Amyotrophic Lateral Sclerosis) OR (Motor Neuron Disease)) AND ((Diabetes) OR (Glucose Intolerance) OR (Hyperglycemia)). Review and original articles were considered.
DM appears not to affect ALS severity, progression, and survival. Contrasting data suggested a protective role of DM on the occurrence of ALS in elderly and an opposite effect in younger subjects.
The actual clinical and pathophysiological correlation between DM and ALS is unclear. Large longitudinal prospective studies are needed. Achieving large sample sizes comparable to those of common complex diseases like DM is a challenge for a rare disease like ALS. Collaborative efforts could overcome this specific issue.
肌萎缩侧索硬化症（ALS）是一种影响运动神经元的退行性疾病。越来越多的证据表明，ALS 可能会影响代谢系统，包括葡萄糖代谢。有几项研究探讨了糖尿病（DM）作为风险和/或预后因素的作用。然而，DM 与 ALS 之间的确切相关性尚未确定。在这篇综述中，我们重点关注 DM 在 ALS 中的作用，研究葡萄糖代谢紊乱如何与 ALS 的病理生理学和病程相互作用的不同假设。
我们进行了独立的 PubMed 文献检索，使用以下搜索词：((ALS) 或 (肌萎缩侧索硬化症) 或 (运动神经元疾病)) 和 ((糖尿病) 或 (葡萄糖耐量异常) 或 (高血糖))。综述和原始文章均被考虑。
DM 似乎不会影响 ALS 的严重程度、进展和生存。相反的数据表明，DM 在老年人群中对 ALS 的发生具有保护作用，而在年轻人群中则具有相反的作用。
DM 和 ALS 之间的实际临床和病理生理学相关性尚不清楚。需要进行大型纵向前瞻性研究。对于像 ALS 这样的罕见疾病，要达到与 DM 等常见复杂疾病可比的大样本量是一项挑战。协作努力可以克服这一特定问题。
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