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Risk factors in Swedish young men for amyotrophic lateral sclerosis in adulthood

Journal article
Authors Maria A I Åberg
Jenny Nyberg
Josefina Robertson
Hans-Georg Kuhn
Linus Schiöler
Hans Nissbrandt
Margda Waern
Kjell Torén
Published in Journal of Neurology
Volume 265
Issue 3
Pages 460–470
ISSN 0340-5354
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Medicine, School of Public Health and Community Medicine
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Institute of Neuroscience and Physiology, Department of Pharmacology
Pages 460–470
Language en
Links dx.doi.org/10.1007/s00415-017-8719-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Community medicine

Abstract

Recent research suggests that the incidence of amyotrophic lateral sclerosis (ALS) may be on the rise. Since ALS becomes predominant in later life, most studies on causal factors are conducted in middle-aged or older populations where potentially important influences from early life can usually not be adequately captured. We aimed to investigate predictors in young Swedish men for ALS in adulthood. Therefore, we performed a prospective cohort study of young men (aged 16-25, n = 1,819,817) who enlisted 1968-2005 and took part in comprehensive conscription examinations. Incident cases of ALS (n = 526) during up to 46 years of follow-up were identified in the National Hospital Register and Swedish Cause of Death Register. Those who developed ALS had lower BMI (body mass index) at conscription than their peers (p = 0.03). The risk of ALS during follow-up was calculated with Cox proportional hazards models. No associations were found with physical fitness, erythrocyte sedimentation rate, or non-psychotic mental disorders. Low overall muscle strength compared to high overall muscle strength [hazard ratio (HR) 1.36; 95% confidence interval (CI) 1.01-1.83] and low BMI (a one-unit increase HR 0.96; 95% CI 0.93-0.99) and lower erythrocyte volume fraction (a one-unit increase HR 0.96; 95% CI 0.92-0.998) were the statistically significant predictors for ALS in adjusted models. These findings provide novel epidemiologic evidence of a prospective association between low overall muscle strength and erythrocyte volume fraction in young men and ALS risk.

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