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Blood biomarkers of carbohydrate, lipid, and apolipoprotein metabolisms and risk of amyotrophic lateral sclerosis: A more than 20-year follow-up of the Swedish AMORIS cohort.
- Source :
- Annals of Neurology; May2017, Vol. 81 Issue 5, p718-728, 11p
- Publication Year :
- 2017
-
Abstract
- <bold>Objective: </bold>To assess the associations of blood biomarkers of carbohydrate, lipid, and apolipoprotein metabolisms with the future risk of amyotrophic lateral sclerosis (ALS).<bold>Methods: </bold>In the Apolipoprotein-related MOrtality RISk study, we enrolled 636,132 men and women during 1985-1996 in Stockholm, Sweden, with measurements of serum glucose, total cholesterol, triglycerides, apolipoprotein B (apoB), and apolipoprotein A-I (apoA-I). Serum low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were either directly measured or calculated from total cholesterol, triglycerides, and apoA-I. The cohort was followed until the end of 2011. We used Cox models and mixed-effects models to, first, estimate the associations between these biomarkers and ALS incidence and, second, to assess the changes of these biomarkers during the 20 years before ALS diagnosis.<bold>Results: </bold>One-unit increase of LDL-C (hazard ratio [HR] = 1.14; 95% confidence interval [CI] = 1.02-1.27), apoB (HR = 1.68; 95% CI = 1.17-2.42), and apoB/apoA-I ratio (HR = 1.90; 95% CI = 1.29-2.78) was associated with a higher incidence of ALS. High glucose level (≥6.11mmol/L) was associated with a lower incidence (HR = 0.62; 95% CI = 0.42-0.93), whereas high LDL-C/HDL-C (≥3.50; HR = 1.50; 95% CI = 1.15-1.96) and high apoB/apoA-I (≥0.90 for men, ≥0.8 for women; HR = 1.41; 95% CI = 1.04-1.90) ratios were associated with a higher incidence. During the 10 years before diagnosis, ALS patients had increasing levels of LDL-C, HDL-C, apoB, and apoA-I, whereas gradually decreasing levels of LDL-C/HDL-C and apoB/apoA-I ratios.<bold>Interpretation: </bold>Alterations in the carbohydrate, lipid, and apolipoprotein metabolisms are associated with ALS risk and may serve as prodromal symptoms decades before ALS diagnosis. The imbalance between apoB and apoA-I as well as between LDL-C and HDL-C may be an etiological mechanism for ALS and needs to be further studied. Ann Neurol 2017;81:718-728. [ABSTRACT FROM AUTHOR]
- Subjects :
- AMYOTROPHIC lateral sclerosis
AMYOTROPHIC lateral sclerosis treatment
BLOOD viscosity
BLOOD as food or medicine
HIGH-density lipoprotein receptors
DIAGNOSIS
APOLIPOPROTEINS
BLOOD sugar
CARBOHYDRATES
HIGH density lipoproteins
LONGITUDINAL method
LOW density lipoproteins
RELATIVE medical risk
DISEASE incidence
ACQUISITION of data
CASE-control method
Subjects
Details
- Language :
- English
- ISSN :
- 03645134
- Volume :
- 81
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Annals of Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 123187934
- Full Text :
- https://doi.org/10.1002/ana.24936