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The role of pre‐morbid diabetes on developing amyotrophic lateral sclerosis
Author(s) -
D'Ovidio F.,
d'Errico A.,
Carnà P.,
Calvo A.,
Costa G.,
Chiò A.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13465
Subject(s) - medicine , amyotrophic lateral sclerosis , diabetes mellitus , hazard ratio , proportional hazards model , population , cohort , cohort study , confidence interval , demography , gerontology , disease , environmental health , endocrinology , sociology
Background and purpose 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 . Methods 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. Results 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. Conclusion The results support the protective role of diabetes toward ALS .