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Statins, diabetes mellitus and prognosis of amyotrophic lateral sclerosis: data from 501 patients of a population‐based registry in southwest Germany
Author(s) -
Schumacher J.,
Peter R. S.,
Nagel G.,
Rothenbacher D.,
Rosenbohm A.,
Ludolph A. C.,
Dorst J.
Publication year - 2020
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.14300
Subject(s) - medicine , amyotrophic lateral sclerosis , body mass index , diabetes mellitus , statin , quartile , hazard ratio , cohort , population , proportional hazards model , incidence (geometry) , prospective cohort study , confidence interval , disease , endocrinology , environmental health , physics , optics
Background and purpose A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS. Methods In all, 501 patients (mean age 65.2 ± 10.9 years; 58.5% male) from the ALS Registry Swabia recruited between October 2010 and April 2016 were included in this prospective cohort study. Data were collected using a standardized questionnaire. Results Statin use ( n = 65) was not associated with overall survival ( P = 0.62). Age of ALS onset in patients with DM was 4.2 years later (95% confidence interval 1.3–7.2 years) than in patients without DM ( P < 0.01). The overall survival of patients with high body mass index at study entry (>27.0 kg/m 2 , upper quartile, n = 127) was prolonged by more than 5 months compared to patients with low body mass index (<22.0 kg/m 2 , lower quartile, n = 123; P = 0.04). Conclusions This study supports the view that statin use is not associated with overall survival of ALS patients, suggesting that statins are not harmful and should not be discontinued in ALS. Furthermore, the delayed onset of ALS in patients with DM may mirror the potentially protective metabolic profile associated with type 2 DM. Consistently, this study provides further evidence that high body mass index is a positive prognostic factor in ALS.