Cristina Moglia1,2, Andrea Calvo1,2, Antonio Canosa1, Davide Bertuzzo1, Paolo Cugnasco1, Luca Solero1, Maurizio Grassano1, Enrica Bersano3,4, Stefania Cammarosano1, Umberto Manera1, Fabrizio Pisano5, Letizia Mazzini3, Laura A Dalla Vecchia6, Gabriele Mora6, Adriano Chiò1,2,7. 1. a ALS Center, 'Rita Levi Montalcini' Department of Neuroscience , University of Turin , Turin , Italy. 2. b Azienda Ospedaliero Universitaria Città della Salute e della Scienza , Turin , Italy. 3. c ALS Center, Department of Neurology , Azienda Ospedaliero Universitaria Maggiore della Carità , Novara , Italy. 4. d Eastern Piedmont University , Novara , Italy. 5. e Salvatore Maugeri Foundation , IRCSS, Scientific Institute of Veruno , Veruno , Italy. 6. f Salvatore Maugeri Foundation , IRCSS, Scientific Institute of Milano , Milano , Italy , and. 7. g Institute of Cognitive Sciences and Technologies , Consiglio Nazionale delle Ricerche , Rome , Italy.
Abstract
OBJECTIVE: To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. METHODS: A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). RESULTS: At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. CONCLUSIONS: This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.
OBJECTIVE: To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. METHODS: A total of 650 ALSpatients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). RESULTS: At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALSpatients. CONCLUSIONS: This study performed on a large population-based cohort of ALSpatients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.