Premorbid body mass index, physical activity, diabetes and cardiovascular disease have been associated with an altered risk of developing amyotrophic lateral sclerosis (ALS).
A very large prospective on UK Biobank was published in BMJ. It permits the study of a range of metabolic parameters and the risk of subsequent diagnosis of ALS.
The UK Biobank is a prospective cohort study of over 500 000 people aged between 39 and 72 years (www.ukbiobank.ac.uk).
The risk of subsequent Amyotrophic Lateral Sclerosis diagnosis in those enrolled prospectively to the UK Biobank was examined in relation to baseline levels of blood high and low density lipoprotein, total cholesterol, total cholesterol:HDL ratio, apolipoproteins A1 and B, triglycerides, glycated haemoglobin A1c and creatinine, plus self-reported exercise and body mass index.
Controlling for age and sex, higher HDL and apoA1 were associated with a reduced risk of Amyotrophic Lateral Sclerosis.
High-density lipoprotein (HDL) is one of the five major groups of lipoproteins. Increasing concentrations of HDL particles are associated with decreasing accumulation of atherosclerosis within the walls of arteries, reducing the risk of vascular diseases. HDL particles are commonly referred to as "good cholesterol",
On contrary higher total cholesterol versus HDL was associated with an increased risk of Amyotrophic Lateral Sclerosis.
Coronary artery disease, cerebrovascular disease and increasing age were also associated with an increased risk of Amyotrophic Lateral Sclerosis.
The association of HDL, apoA1 and LDL levels with risk of Amyotrophic Lateral Sclerosis contributes to an increasing body of evidence that the premorbid metabolic landscape may play a role in ALS pathogenesis, at least for a subset of patients.