Diabetes, high cholesterol linked with lower risk of developing ALS
Conditions tied to faster progression, worse survival in presence of MNDs
People with diabetes or high cholesterol may be less likely to develop amyotrophic lateral sclerosis (ALS) or other motor neuron diseases (MNDs), but heart and metabolism problems are linked with faster disease progression and worse survival rates among people who already have MND.
That’s according to the study, “Association between cardiometabolic diseases and the risk and progression of motor neuron diseases in Sweden: a population-based case-control study,” which was published in The Lancet Regional Health-Europe.
“Our findings underscore the importance of considering [cooccurring health issues] in the treatment and management of individuals with motor neuron diseases,” Charilaos Chourpiliadis, doctoral student at the Karolinska Institutet in Sweden and co-author of the study, said in a university news story. “Identifying these associations can contribute to tailored treatments and provide patients with an improved quality of life.”
MNDs are a group of neurological disorders marked by the gradual loss of voluntary muscle movement. ALS, the most common of these diseases, is caused by the progressive dysfunction and death of motor neurons, the specialized nerve cells that control voluntary movements.
Cardiometabolic diseases are a broad category of disorders that affect the heart and metabolism, ranging from heart failure and high blood pressure to diabetes and high cholesterol. While some research has suggested a potential link between cardiometabolic conditions and MNDs, the results have been inconsistent, and it’s unclear if the presence of these conditions influence the risk of developing MND or affects disease progression.
Links between cardiometabolic diseases, MNDs
Here, scientists analyzed data on 1,463 people with MND, more than 1,000 with ALS. Around half the participants had cardiometabolic diseases. Data on these patients were compared against data from the broader population, as well as data from siblings and spouses, to inform mathematical calculations on how cardiometabolic diseases affect ALS risk.
“Our study represents the most comprehensive investigation to date of the influence of [cardiometabolic diseases] on the risk and progression of MND, underscoring the importance of closely monitoring the cardiometabolic health of MND patients during the course of the disease,” the researchers wrote.
People diagnosed with high cholesterol (hypercholesterolemia) or diabetes type 2 were less likely to develop MND in subsequent years, the results showed. However, cardiometabolic diseases were generally more common among MND patients in the year right before a diagnosis, which is likely due to not-yet diagnosed ALS putting strain on the heart and associated systems.
“This may indicate the complex relationship between metabolic diseases and MND. Prolonged hypercholesterolemia and type 2 diabetes may have a protective effect against ALS. On the other hand, ALS-related pathologies might impact metabolism and contribute to the development of hypercholesterolemia or type 2 diabetes,” Chourpiliadis said.
The researchers also assessed how heart and metabolic conditions affected ALS progression among people with the disease. Results showed many cardiometabolic conditions, including heart failure, high blood pressure (hypertension), ischemic heart disease, and high cholesterol levels were associated with faster decline in functional scores. After accounting for differences in functional decline, MND patients with a history of any heart disease, as well as those with abnormal heart rhythms (arrhythmia), heart failure, hypertension, and high cholesterol levels, all had significantly worse mortality rates.
“History of diabetes mellitus type 2 or hypercholesterolemia was associated with a lower risk for future MND, whereas MND patients with a history of any [cardiovascular disease], cardiac arrhythmia, heart failure, hypertension, and hypercholesterolemia before diagnosis had an increased mortality and faster functional decline after diagnosis,” the scientists wrote.
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