TY - JOUR
T1 - Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis
T2 - A Population-Based Case-Control Study
AU - Filippini, Tommaso
AU - Fiore, Maria
AU - Tesauro, Marina
AU - Malagoli, Carlotta
AU - Consonni, Michela
AU - Violi, Federica
AU - Arcolin, Elisa
AU - Iacuzio, Laura
AU - Oliveri Conti, Gea
AU - Cristaldi, Antonio
AU - Zuccarello, Pietro
AU - Zucchi, Elisabetta
AU - Mazzini, Letizia
AU - Pisano, Fabrizio
AU - Gagliardi, Ileana
AU - Patti, Francesco
AU - Mandrioli, Jessica
AU - Ferrante, Margherita
AU - Vinceti, Marco
PY - 2020/1/30
Y1 - 2020/1/30
N2 - Background: Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disease of the motor neurons. The etiology of ALS remains largely unknown, particularly with reference to the potential environmental determinants. Methods: We performed a population-based case-control study in four provinces from both Northern and Southern Italy in order to assess non-genetic ALS risk factors by collecting through tailored questionnaires information about clinical and lifestyle factors. We estimated ALS risk by calculating odds ratio (OR) with its 95% confidence interval (CI) using unconditional logistic regression models adjusted for sex, age and educational attainment. Results: We recruited 230 participants (95 cases and 135 controls). We found a possible positive association of ALS risk with trauma, particularly head trauma (OR = 2.61, 95% CI 1.19-5.72), electric shock (OR = 2.09, 95% CI 0.62-7.06), and some sports, although at a competitive level only. In addition, our results suggest an increased risk for subjects reporting use of private wells for drinking water (OR = 1.38, 95% CI 0.73-2.27) and for use of herbicides during gardening (OR = 1.95, 95% CI 0.88-2.27). Conversely, there was a suggestion of an inverse association with overall fish consumption (OR = 0.27, 95% CI 0.12-0.60), but with no dose-response relation. Consumption of some dietary supplements, namely those containing amino acids and, in the Southern Italy population, vitamins and minerals such as selenium, seemed associated with a statistically imprecise increased risk. Conclusions: Our results suggest a potential etiologic role a number of clinical and lifestyle factors with ALS risk. However, caution is needed due to some study limitations. These include the small sample size and the low number of exposed subjects, which affect statistical precision of risk estimates, the potential for exposure misclassification, and the uncertainties about mechanisms underpinning the possible association between these factors and disease risk.
AB - Background: Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disease of the motor neurons. The etiology of ALS remains largely unknown, particularly with reference to the potential environmental determinants. Methods: We performed a population-based case-control study in four provinces from both Northern and Southern Italy in order to assess non-genetic ALS risk factors by collecting through tailored questionnaires information about clinical and lifestyle factors. We estimated ALS risk by calculating odds ratio (OR) with its 95% confidence interval (CI) using unconditional logistic regression models adjusted for sex, age and educational attainment. Results: We recruited 230 participants (95 cases and 135 controls). We found a possible positive association of ALS risk with trauma, particularly head trauma (OR = 2.61, 95% CI 1.19-5.72), electric shock (OR = 2.09, 95% CI 0.62-7.06), and some sports, although at a competitive level only. In addition, our results suggest an increased risk for subjects reporting use of private wells for drinking water (OR = 1.38, 95% CI 0.73-2.27) and for use of herbicides during gardening (OR = 1.95, 95% CI 0.88-2.27). Conversely, there was a suggestion of an inverse association with overall fish consumption (OR = 0.27, 95% CI 0.12-0.60), but with no dose-response relation. Consumption of some dietary supplements, namely those containing amino acids and, in the Southern Italy population, vitamins and minerals such as selenium, seemed associated with a statistically imprecise increased risk. Conclusions: Our results suggest a potential etiologic role a number of clinical and lifestyle factors with ALS risk. However, caution is needed due to some study limitations. These include the small sample size and the low number of exposed subjects, which affect statistical precision of risk estimates, the potential for exposure misclassification, and the uncertainties about mechanisms underpinning the possible association between these factors and disease risk.
KW - Aged
KW - Amyotrophic Lateral Sclerosis/epidemiology
KW - Case-Control Studies
KW - Female
KW - Humans
KW - Italy/epidemiology
KW - Life Style
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Odds Ratio
KW - Population Health
KW - Research Design
KW - Risk Factors
KW - Selenium
U2 - 10.3390/ijerph17030857
DO - 10.3390/ijerph17030857
M3 - Article
C2 - 32019087
VL - 17
JO - Int J Environ Res Public Health
JF - Int J Environ Res Public Health
SN - 1660-4601
IS - 3
ER -