Abstract
ALS etiology and prognostic factors are mostly unknown. Metabolic diseases and especially diabetes mellitus (DM) have been variously related to ALS. However, pieces of evidence have been variegated and often conflicting so far. This review aims to give an overview of recent contributions focusing on the relationship between DM and ALS. DM seems to reduce the risk of developing ALS if diagnosed at a younger age; conversely, when diagnosed at an older age, DM seems protective against ALS. Such a relationship was not confirmed in Asian countries where DM increases the risk of ALS independently of the age of onset. Interestingly, DM does not affect ALS prognosis, possibly weakening the potential causal relationship between the two diseases. However, since most studies are observational, it is difficult to state the exact nature of such a relationship and several hypotheses have been made. A recent study using Mendelian randomization suggested that DM is indeed protective against ALS in the European population. However, these analyses are not without limits and further evidence is needed. DM is usually the core of a larger metabolic syndrome. Thus, other metabolic changes such as dyslipidemia, body mass index, and cardiovascular diseases should be collectively considered. Finally, hypermetabolism usually found in ALS patients should be considered too since all these metabolic changes could be compensation (or the cause) of the higher energy expenditure.
Highlights
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motor neurons
Studies not reporting an explicit link between Diabetes mellitus (DM) and ALS were not included in this count
Recent literature converged into stating that DM diagnosed at younger ages has a detrimental or null effect on the development of ALS; when DM is diagnosed at older ages, as it happens more commonly, it shows a protective effect on the ALS risk
Summary
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motor neurons. It causes the paralysis of voluntary muscles, leading to death, usually for respiratory failure, in 2 to 4 years from symptoms onset [1]. The etiology of ALS is unknown but it is thought to involve both genetic and environmental factors [1]. The difficulty in identifying risk factors for ALS reflects the complexity of the Rosario Vasta and Fabrizio D’Ovidio contributed to this work. Diabetes mellitus (DM) is a chronic disease caused by dysfunctional use, or the lack, of insulin and resulting in impaired blood glucose regulation. DM can be classified as type 1 (T1DM) and type 2 (T2DM) depending on the deficient insulin production or on the body’s ineffective use of insulin, respectively [3]. DM has an 8.5% prevalence among the adult population; in 2014, 422 million people worldwide were affected by DM [4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
