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Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

Author

Listed:
  • Tommaso Filippini

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
    Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy)

  • Maria Fiore

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Marina Tesauro

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy)

  • Carlotta Malagoli

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy)

  • Michela Consonni

    (Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy)

  • Federica Violi

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
    Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy
    Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy)

  • Elisa Arcolin

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy)

  • Laura Iacuzio

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
    Department of Public Health, Local Health Unit, 41121 Modena, Italy)

  • Gea Oliveri Conti

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Antonio Cristaldi

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Pietro Zuccarello

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Elisabetta Zucchi

    (Neurology Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy)

  • Letizia Mazzini

    (ALS Centre Department of Neurology, ‘Maggiore della Carità’ University Hospital, 28100 Novara, Italy)

  • Fabrizio Pisano

    (Neurological Rehabilitation Division, Policlinico San Marco di Zingonia, 24046 Zingonia (BG), Italy)

  • Ileana Gagliardi

    (ALS Centre Department of Neurology, ‘Maggiore della Carità’ University Hospital, 28100 Novara, Italy)

  • Francesco Patti

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Jessica Mandrioli

    (Neurology Unit, Department of Neuroscience, S. Agostino Estense Hospital, Azienda Ospedaliero Universitaria di Modena, 41126 Modena, Italy)

  • Margherita Ferrante

    (Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy)

  • Marco Vinceti

    (CREAGEN—Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
    Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA)

Abstract

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.

Suggested Citation

  • Tommaso Filippini & Maria Fiore & Marina Tesauro & Carlotta Malagoli & Michela Consonni & Federica Violi & Elisa Arcolin & Laura Iacuzio & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(3), pages 1-17, January.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:3:p:857-:d:314375
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    Citations

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    Cited by:

    1. Tommaso Filippini & Marina Tesauro & Maria Fiore & Carlotta Malagoli & Michela Consonni & Federica Violi & Laura Iacuzio & Elisa Arcolin & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Reply to Comment on “Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study”," IJERPH, MDPI, vol. 17(18), pages 1-3, September.
    2. Giorgia Adani & Tommaso Filippini & Caterina Garuti & Marcella Malavolti & Giulia Vinceti & Giovanna Zamboni & Manuela Tondelli & Chiara Galli & Manuela Costa & Marco Vinceti & Annalisa Chiari, 2020. "Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy," IJERPH, MDPI, vol. 17(21), pages 1-18, October.
    3. Tommaso Filippini & Jessica Mandrioli & Carlotta Malagoli & Sofia Costanzini & Andrea Cherubini & Giuseppe Maffeis & Marco Vinceti, 2021. "Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study," IJERPH, MDPI, vol. 18(3), pages 1-14, January.
    4. Tommaso Filippini & Marina Tesauro & Maria Fiore & Carlotta Malagoli & Michela Consonni & Federica Violi & Laura Iacuzio & Elisa Arcolin & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(8), pages 1-13, April.

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