JAMA: A study of patients in Denmark suggests that type 2 diabetes may be
associated with a reduced risk for the fatal neurodegenerative disease
amyotrophic lateral sclerosis (ALS), according to an article published
online by JAMA Neurology. Recent reports have suggested a protective association between
vascular risk factors, such as obesity or higher body mass index (BMI),
higher cholesterol levels and hyperlipidemia with ALS incidence and
survival. Patients with type 2 diabetes have, on average, higher BMI,
elevated blood lipid levels and defective energy metabolism. However,
the association between diabetes and ALS has not been widely explored.
Marianthi-Anna Kioumourtzoglou, Sc.D., of the Harvard T.H. Chan
School of Public Health, Boston, and coauthors, examined the association
between diabetes, obesity and ALS using data from Danish National
Registers for 3,650 patients diagnosed with ALS between 1982 and 2009.
The average age at diagnosis was 65.4 years. They were compared with
365,000 healthy control patients.
The authors also identified 9,294 patients with diabetes at least
three years prior to the index date (the date of ALS diagnosis or the
same date for the matched controls), 55 of whom were subsequently
diagnosed with ALS. The average age of the first diabetes-related
diagnosis was 59.7 years.
The study found that diabetes, but not obesity, was associated with a
reduced risk of ALS. The association with diabetes was affected by both
age at ALS diagnosis and age at diabetes diagnosis, with older age at
diagnosis for either disease associated with lower risk for ALS.
“We conducted a nationwide, population-based study and observed an
overall protective association between diabetes and ALS diagnosis, with
the suggestion that type 2 diabetes is protective and type 1 diabetes is
a risk factor. Although the mechanisms underlying this association
remain unclear, our findings focus further attention on the role of
energy metabolism in ALS pathogenesis,” the study concludes.
(JAMA Neurol. Published online June 1, 2015. doi:10.1001/jamaneurol.2015.0910. Available pre-embargo to the media at http://media.jamanetwork.com.)