Risk Factors For Amyotrophic Lateral Sclerosis

Background:Amyotrophic lateral sclerosis(ALS)is a fatal neurodegenerative disease mainly involving central and peripheral motor neurons.It usually progresses rapidly without effective treatment.The etiology of ALS is not clear,and current researchers believe that both genetic and environmental factors contribute to ALS,though the results are inconsistent.In China,there is a preliminary exploration of genetic factors,but the study on environmental factors is relatively inadequate,which needs to be further clarified.Objective:To investigate the protective or harmful effects of different environmental factors on ALS,and explore the possible etiology of ALS for further study.Methods:Case-control study were used.The cases consisted of 123 patients who were admitted to our hospital from 2013 to 2016.Correspondingly,239 healthy controls were matched by sex and age with 1:2 in the form of questionnaires,including general situation,family history,complications,trauma,smoking,drinking,BMI,activity,occupation,etc.Statistical analysis and description were performed with SPSS24.0.The correlation between the two groups was analyzed by x2 test.The OR value and 95%confidence interval were calculated by logistic regression analysis.The factors with significant differences in univariate analysis were included in the conditional logistic regression model for multivariate regression analysis.The significant level was a= 0.05.Results:The risk factors of ALS include head trauma(OR=3.397,95%[1.298,8.893],P=0.013),drinking(OR=1.760,95%CI[1.110,2.790],p=0.016),smoking(OR=3.196,95%[1.375,7.427],P=0.351),low BMI(OR=1.231,95%CI[1.115,1.319],P=0.000),worker,famers or related works(OR=2.539,95%[1.441,4.475],P=0.001,30-34 yrs);factors that reduce incidence of ALS including hypertension(OR=0.526,95%[0.313,0.883],P=0.015),severe physical activities(OR=0.808,95%[0.711,0.918],P=0.001),longer duration of education(OR=0.183,95%[0.078,0.428],P=0.000,>12 yrs),reading more than 20 minutes per day(OR=0.225,95%[0.126,0.516],P=0.000,13-30 yrs),retirement or unemployment(OR=0.040,95%[0.005,0.291],P=0.000,30-34 yrs);family history of neurologic disorder,general trauma,years and numbers of smoking,artistic activities,engaged in service industry and other factors did not show correlation with ALS.Conclusions:Head trauma,alcohol consumption,smoking,low BMI,workers or farmers are risk factors for ALS;high blood pressure,severe physical activity,longer duration of education,reading more than 20 minutes per day,retirement or unemployment are protective factors for ALS;whether there is a connection between ALS and family history,general trauma,years or numbers of smoking,artistic activities,engaged in service industry and other factors need to be confirmed by further study.