Smoking and risk for amyotrophic lateral sclerosis: analysis of the EPIC cohort.
Gallo, V.; Bueno de Mesquita, H.B.; Vermeulen, R.C.H.; Andersen, P.M.; Kyrozis, A.; Linseisen, J.; Kaaks, R.; Allen, N.E.; Roddam, A.W.; Boshuizen, H.C.; Peeters, P.H.M.; Palli, D.; Mattiello, A.; Sieri, S.; Tumino, R.; Jimenez-Martin, J.M.; Diaz, M.J.; Suarez, L.R.; Trichopoulou, A.; Agudo, A.; Arriola, L.; Barricante-Gurrea, A.; Bingham, S.; Khaw, K.T.; Manjer, J.; Lindkvist, B.; Overvad, K.; Bach, F.W.; Tjonneland, A.; Olsen, A.; Bergmann, M.M.; Boeing, H.; Clavel-Chapelon, F.; Lund, E.; Hallmans, G.; Middleton, L.; Vineis, P.; Riboli, E.
(2009) Annals of Neurology, volume 65, issue 4, pp. 378 - 385
(Article)
Abstract
OBJECTIVE: Cigarette smoking has been reported as "probable" risk factor for Amyotrophic Lateral Sclerosis (ALS), a poorly understood disease in terms of aetiology. The extensive longitudinal data of the European Prospective Investigation into Cancer and Nutrition (EPIC) were used to evaluate age-specific mortality rates from ALS and the role of
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cigarette smoking on the risk of dying from ALS. METHODS: A total of 517,890 healthy subjects were included, resulting in 4,591,325 person-years. ALS cases were ascertained through death certificates. Cox hazard models were built to investigate the role of smoking on the risk of ALS, using packs/years and smoking duration to study dose-response. RESULTS: A total of 118 subjects died from ALS, resulting in a crude mortality rate of 2.69 per 100,000/year. Current smokers at recruitment had an almost two-fold increased risk of dying from ALS compared to never smokers (HR = 1.89, 95% C.I. 1.14-3.14), while former smokers at the time of enrollment had a 50% increased risk (HR = 1.48, 95% C.I. 0.94-2.32). The number of years spent smoking increased the risk of ALS (p for trend = 0.002). Those who smoked more than 33 years had more than a two-fold increased risk of ALS compared with never smokers (HR = 2.16, 95% C.I. 1.33-3.53). Conversely, the number of years since quitting smoking was associated with a decreased risk of ALS compared with continuing smoking. INTERPRETATION: These results strongly support the hypothesis of a role of cigarette smoking in aetiology of ALS. We hypothesize that this could occur through lipid peroxidation via formaldehyde exposure.
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ISSN: 0364-5134
Publisher: John Wiley and Sons Inc.
(Peer reviewed)