Endogenous female reproductive hormones and the risk of amyotrophic lateral sclerosis

被引:57
作者
de Jong, Sonja [1 ]
Huisman, Mark [1 ]
Sutedja, Nadia [1 ]
van der Kooi, Anneke [2 ]
de Visser, Marianne [2 ]
Schelhaas, Jurgen [3 ]
van der Schouw, Yvonne [4 ]
Veldink, Jan [1 ]
van den Berg, Leonard [1 ]
机构
[1] Univ Med Ctr Utrecht, Dept Neurol, Rudolf Magnus Inst Neurosci, NL-3584 CX Utrecht, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Neurol, NL-1105 AZ Amsterdam, Netherlands
[3] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav,Ctr Neurosci, NL-6525 ED Nijmegen, Netherlands
[4] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, NL-3584 CX Utrecht, Netherlands
关键词
ALS; Amyotrophic lateral sclerosis; Estrogens; Hormones; Risk; Population-based; ESTROGEN; EPIDEMIOLOGY; PROGNOSIS; DISEASE;
D O I
10.1007/s00415-012-6665-5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The pathogenesis of amyotrophic lateral sclerosis (ALS) is considered to be multifactorial. Several epidemiological studies showed a lower incidence of ALS in women than in men. This suggests a possible protective effect of female reproductive hormones. The aim of this study was to investigate the association between female reproductive hormones and ALS. We performed a population-based, case-control study in the Netherlands between 1st January 2006 and 1st December 2009. Only women with a natural menopause were included in the analysis. A total of 209 (85 %) of 246 female patients and 672 (93 %) of 719 controls returned a questionnaire on reproductive history to calculate the reproductive time-span and lifetime endogenous estrogen exposure (calculated by subtracting the duration of pregnancies and of oral contraceptive use, and the number of post-ovulatory weeks from the reproductive time-span). 131 (63 %) patients and 430 (64 %) age-matched, population-based controls had experienced a natural menopause. Multivariate analysis showed that increasing the reproductive time-span by a year decreases the risk of ALS with an OR of 0.95 (p = 0.005). Each year longer reproductive time-span [HR 0.90 (p = 0.01)] and lifetime endogenous estrogen exposure [HR 0.96 (p = 0.025)] were associated with a longer survival of ALS patients. The positive association of a longer reproductive time-span and susceptibility and survival of ALS might imply that longer exposure to female reproductive hormones has a neuroprotective effect on motor neurons.
引用
收藏
页码:507 / 512
页数:6
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