scholarly journals The links between diabetes mellitus and amyotrophic lateral sclerosis

2021 ◽  
Vol 42 (4) ◽  
pp. 1377-1387
Author(s):  
Rosario Vasta ◽  
Fabrizio D’Ovidio ◽  
Giancarlo Logroscino ◽  
Adriano Chiò
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Diseases ◽  
Age Of Onset ◽  
European Population ◽  
Metabolic Changes ◽  
Exact Nature ◽  
Younger Age ◽  
Als Patients ◽  
The Relationship ◽  
Lateral Sclerosis

AbstractALS etiology and prognostic factors are mostly unknown. Metabolic diseases and especially diabetes mellitus (DM) have been variously related to ALS. However, pieces of evidence have been variegated and often conflicting so far. This review aims to give an overview of recent contributions focusing on the relationship between DM and ALS. DM seems to reduce the risk of developing ALS if diagnosed at a younger age; conversely, when diagnosed at an older age, DM seems protective against ALS. Such a relationship was not confirmed in Asian countries where DM increases the risk of ALS independently of the age of onset. Interestingly, DM does not affect ALS prognosis, possibly weakening the potential causal relationship between the two diseases. However, since most studies are observational, it is difficult to state the exact nature of such a relationship and several hypotheses have been made. A recent study using Mendelian randomization suggested that DM is indeed protective against ALS in the European population. However, these analyses are not without limits and further evidence is needed. DM is usually the core of a larger metabolic syndrome. Thus, other metabolic changes such as dyslipidemia, body mass index, and cardiovascular diseases should be collectively considered. Finally, hypermetabolism usually found in ALS patients should be considered too since all these metabolic changes could be compensation (or the cause) of the higher energy expenditure.

Intelligibility and the Acoustic Characteristics of Speech in Amyotrophic Lateral Sclerosis (ALS)

1994 ◽  
Vol 37 (3) ◽  
pp. 496-503 ◽  
Author(s):  
Moira Mulligan ◽  
Joseph Carpenter ◽  
Joanne Riddel ◽  
Maureen Kenny Delaney ◽  
Gary Badger ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Transition Rate ◽  
Transition Rates ◽  
Single Word ◽  
Acoustic Parameters ◽  
Acoustic Characteristics ◽  
Als Patients ◽  
The Relationship ◽  
Lateral Sclerosis

The purpose of this study was to analyze the changes in specific speech parameters in 14 patients, 7 dysarthric and 7 non-dysarthric, with amyotrophic lateral sclerosis (ALS), over a 6-month period. Measurements of single word intelligibility, F2 formant trajectories (extent, duration and rate) and diadochokinetic rate showed decreased performance in dysarthric patients as compared to non-dysarthric patients at baseline. F2 transition rates of less than 4 Hz/msec were seen only in dysarthric ALS patients. A relationship between the F2 transition rate and single word intelligibility was noted for patients with moderate to high intelligibility, but at lower levels of intelligibility the F2 rate reached a plateau despite continued decline in intelligibility. Our results support the need for frequent evaluation of dysarthric ALS patients to better understand the relationship between intelligibility and the acoustic parameters of speech.

scholarly journals Impact of SARS-CoV-2 Infection Among Non-Invasive Ventilated ALS Patients

2021 ◽  
pp. 1-3
Author(s):  
Miguel Oliveira Santos ◽  
Sara Domingues ◽  
Marta Gromicho ◽  
Susana Pinto ◽  
Mamede de Carvalho
Keyword(s):  
Age Of Onset ◽  
Severe Disease ◽  
Neuromuscular Diseases ◽  
Supplemental Oxygen ◽  
Total Recovery ◽  
Non Invasive ◽  
Respiratory Involvement ◽  
Als Patients ◽  
The Impact ◽  
Lateral Sclerosis

Background: The impact of SARS-CoV-2 infection among neuromuscular diseases with respiratory involvement, including amyotrophic lateral sclerosis (ALS), is still to be elucidated. Objectives: We aim to characterize the clinical outcome of ALS patients non-invasive ventilated (NIV), following SARS-CoV-2 infection. Methods: We analyzed retrospectively our patients followed regularly at our ALS clinic, from the beginning of the COVID-19 pandemic (middle March 2020) to March 2021. We included patients on NIV with a documented SARS-CoV-2 infection. We recorded demographic and clinical data, including from the acute infectious illness. Results: Three men with spinal-onset ALS are described, mean age of onset was 55±9.1 years (45–61), and mean disease duration was 17.5±15.9 months (6.1–41). All of them were wheelchair-bounded, with a mean ALSFRS-R of 15.3±0.6 (15–16). One patient used NIV 15 hours/day, 2 between 4 to 7 hours/day, and all used assisted coughing twice daily. None had coexistent comorbidities. They were managed for SARS-CoV-2 infection as outpatients with fluticasone, bronchodilators, azithromycin and increasing frequency of assisted coughing. Supplemental oxygen (mean of 2 liters per minute) was needed in two patients, and one required NIV also during the daytime. Total recovery from SARS-CoV-2 infection was observed in all, despite being in an advanced stage of their disease, with severe respiratory involvement. Conclusions: Prompt medical treatment is recommended for ALS patients with severe disease infected by SARS-CoV-2.

scholarly journals Effects and Mechanisms of Probiotics, Prebiotics, Synbiotics, and Postbiotics on Metabolic Diseases Targeting Gut Microbiota: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3211
Author(s):  
Hang-Yu Li ◽  
Dan-Dan Zhou ◽  
Ren-You Gan ◽  
Si-Yu Huang ◽  
Cai-Ning Zhao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Intestinal Barrier ◽  
Intestinal Barrier Function ◽  
Clinical Effects ◽  
The One ◽  
The Relationship ◽  
Gut Microbiota Composition

Metabolic diseases are serious threats to public health and related to gut microbiota. Probiotics, prebiotics, synbiotics, and postbiotics (PPSP) are powerful regulators of gut microbiota, thus possessing prospects for preventing metabolic diseases. Therefore, the effects and mechanisms of PPSP on metabolic diseases targeting gut microbiota are worth discussing and clarifying. Generally, PPSP benefit metabolic diseases management, especially obesity and type 2 diabetes mellitus. The underlying gut microbial-related mechanisms are mainly the modulation of gut microbiota composition, regulation of gut microbial metabolites, and improvement of intestinal barrier function. Moreover, clinical trials showed the benefits of PPSP on patients with metabolic diseases, while the clinical strategies for gestational diabetes mellitus, optimal formula of synbiotics and health benefits of postbiotics need further study. This review fully summarizes the relationship between probiotics, prebiotics, synbiotics, postbiotics, and metabolic diseases, presents promising results and the one in dispute, and especially attention is paid to illustrates potential mechanisms and clinical effects, which could contribute to the next research and development of PPSP.

scholarly journals The Relationship between the Level of Glycosylated hemoglobin (HbA1c) with The Incidence Rate of Diabetic Foot in H. Adam Malik General Hospital

2018 ◽  
Vol 5 (1) ◽  
pp. 3404-3406
Author(s):  
Fernando Silalahi Marshal, ◽  
Doddy Prabisma Pohan ◽  
Aznan Lelo
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Metabolic Diseases ◽  
Glycosylated Hemoglobin ◽  
Reference Value ◽  
Total Sample ◽  
Uncontrolled Diabetes ◽  
The Mean ◽  
The Relationship ◽  
Diabetes Melitus

Background : Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia that occurs due to insulin secretion abnormalities, insulin work or both. Most Diabetes Melitus treatments are always associated with diabetic ulcers. Death rates and amputation rates are still high, respectively at 32.5% and 23.5%. The fate of patients with post-amputation Diabetes Melitus is still very bad, as many as 14.3% will die within a year after amputation and 37% will die 3 years after amputation. It has been  mentioned in previous clinical studies that uncontrolled diabetes mellitus was associated with elevated HbA1c  levels associated with the development of retinopathy as well as other complications, with a research reference value r = 0.079. Methods : The study involved Diabetes Melitus patients with diabetic foot diagnosis in Thoracic, Cardiac, and  Vascular  Surgery Polyclinic Department of Surgical and Inpatient Surgery RSUP H. Adam Malik Medan  period  January 2014- December 2016 with a total sample of 70 people. Result : The mean age of study subjects was 55.65 + 12.25. In the table shows that the study subjects based on the most gender were men with 47 subjects (67%). The mean of Glycosilated hemoglobin (HbA1c) was 6.4 + 2.44 mg / dL with the most patients found  at HbA1c <7 mg / dL level of  49 patients (70%). The result of the analysis is p = 0.0001 (p <0,05) this means there is significant relation between Glycosilated hemoglobin (HbA1c) and diabetic foot. Also obtained OR = 3.1 (CI = 95%, p <0.05). Conclusion: Bivariatically there was a significant correlation between Glycosilated hemoglobin (HbA1c) and diabetic foot with p = 0.0001 and Odd Ratio of OR = 3,1 (CI = 95%, p <0,05). For the mean result of Glycosilated hemoglobin (HbA1c) was 6.4 + 2.44 mg / dL with the highest HbA1c <7 mg / dL of 49 patients (70%).

scholarly journals Younger age of onset in familial amyotrophic lateral sclerosis is a result of pathogenic gene variants, rather than ascertainment bias

2018 ◽  
Vol 90 (3) ◽  
pp. 268-271 ◽  
Author(s):  
Puja R Mehta ◽  
Ashley R Jones ◽  
Sarah Opie-Martin ◽  
Aleksey Shatunov ◽  
Alfredo Iacoangeli ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Ascertainment Bias ◽  
Gene Variants ◽  
Gene Variant ◽  
Younger Age ◽  
Sporadic Als ◽  
The Mean ◽  
Familial Als ◽  
Lateral Sclerosis ◽  
Pathogenic Gene

ObjectiveAmyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease of motor neurons with a median survival of 2 years. Familial ALS has a younger age of onset than apparently sporadic ALS. We sought to determine whether this younger age of onset is a result of ascertainment bias or has a genetic basis.MethodsSamples from people with ALS were sequenced for 13 ALS genes. To determine the effect of genetic variation, age of onset was compared in people with sporadic ALS carrying a pathogenic gene variant and those who do not; to determine the effect of family history, we compared those with genetic sporadic ALS and familial ALS.ResultsThere were 941 people with a diagnosis of ALS, 100 with familial ALS. Of 841 with apparently sporadic ALS, 95 carried a pathogenic gene variant. The mean age of onset in familial ALS was 5.3 years younger than for apparently sporadic ALS (p=6.0×10−5, 95% CI 2.8 to 7.8 years). The mean age of onset of genetic sporadic ALS was 2.9 years younger than non-genetic sporadic ALS (p=0.011, 95% CI 0.7 to 5.2 years). There was no difference between the mean age of onset in genetic sporadic ALS and familial ALS (p=0.097).ConclusionsPeople with familial ALS have an age of onset about 5 years younger than those with apparently sporadic ALS, and we have shown that this is a result of Mendelian gene variants lowering the age of onset, rather than ascertainment bias.

scholarly journals Cognition, Behavior, and Respiratory Function in Amyotrophic Lateral Sclerosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Adriana M. Strutt ◽  
Jennette Palcic ◽  
John G. Wager ◽  
Courtney Titus ◽  
Claire MacAdam ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Frontal Lobe ◽  
Cognitive Abilities ◽  
Neuropsychological Performance ◽  
Neuropsychological Assessments ◽  
Clinically Significant ◽  
Als Patients ◽  
Executive Functioning Deficits ◽  
The Relationship ◽  
Lateral Sclerosis

Objective. To examine the relationship between respiratory functioning and neuropsychological performance, mood, and frontal-lobe-mediated behaviors in ALS patients. Methods. Forty-four patients with probable or definite ALS (El Escorial criteria) completed comprehensive pulmonary and neuropsychological assessments as part of their baseline neurological evaluation. Based on their full vital respiratory capacity, 24 and 20 patients were classified as having impaired or intact respiration, respectively. Results. Comparable demographic characteristics, neuropsychological performance, and self-reported mood symptoms were found between ALS patients with intact versus impaired respiration. However, more respiratory-impaired patients were reported by their caregivers as having clinically significant impairments in frontal-lobe-mediated behaviors. Nevertheless, declines in behavior were evidenced from pre- to post-ALS symptom onset for both respiratory groups, and exploratory analyses revealed greater executive functioning deficits in patients with bulbar versus limb onset as well as respiratory-impaired patients not receiving pulmonary interventions versus those utilizing such interventions at the time of testing. Conclusions. Results suggest that the respiratory insufficiency of ALS patients may potentially produce irreversible deficits in executive functioning; yet once treated, impairments in more basic cognitive abilities may be less evident.

Epidemiology of Amyotrophic Lateral Sclerosis in the Republic of Cyprus: A 25-Year Retrospective Study

2017 ◽  
Vol 48 (1-2) ◽  
pp. 79-85 ◽  
Author(s):  
Christiana A. Demetriou ◽  
Petros M. Hadjivasiliou ◽  
Kleopas A. Kleopa ◽  
Yiolanda P. Christou ◽  
Eleni Leonidou ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Age Of Onset ◽  
Age At Onset ◽  
Positive Family History ◽  
Temporal Trends ◽  
Male Predominance ◽  
The Republic ◽  
Republic Of Cyprus ◽  
Als Patients ◽  
Lateral Sclerosis

Introduction: Amyotrophic lateral sclerosis (ALS) is a rare, rapidly progressive neurodegenerative disease. Despite wide variability in the incidence and prevalence of ALS, there is evidence of positive temporal trends and an increase in incidence with age. The aim of this study was to conduct a detailed epidemiological investigation of ALS in Cyprus. Methods: All registered Cypriot ALS patients in the Republic of Cyprus from January 1985 until December 2014 were included. Socio-demographic information was extracted from patient files. Results: The study identified 179 ALS patients, of whom 7 had a positive family history. The mean age at onset was 58.6 years and a slight male predominance was observed. Average annual crude incidence was 1.26 cases/100,000 person-years and at the beginning of 2015, prevalence of ALS was 7.9 cases/100,000 population. Both incidence and prevalence displayed an increasing trend, even after age-standardization of incidence rates. Conclusions: Incidence, prevalence and main socio-demographic characteristics of ALS in Cyprus were similar to those of other European countries, without any geographic clustering of the disease. Additionally, an increased incidence through the years was confirmed. However, observations such as a higher male prevalence and a younger mean age of onset compared to published literature require further investigation.

scholarly journals Relationship among stress, depression, cardiovascular and metabolic changes and physical exercise

2016 ◽  
Vol 29 (1) ◽  
pp. 23-36
Author(s):  
Andrea Sanches ◽  
Rafaela Costa ◽  
Fernanda Klein Marcondes ◽  
Tatiana Sousa Cunha
Keyword(s):  
Physical Exercise ◽  
Chronic Stress ◽  
Metabolic Diseases ◽  
Modern Society ◽  
Metabolic Changes ◽  
Beneficial Effects ◽  
Primary Stress ◽  
Control Objective ◽  
Stress Mediators ◽  
The Relationship

Abstract Introduction: Stress is considered one of the most significant health problems in modern society. It can be characterized as any changes in the homeostasis of an individual that require an adaptive response. An imbalance in the secretion of the primary stress mediators may be responsible for the onset and development of several diseases. Thus, chronic stress has been recognized as a risk factor for depression as well as cardiovascular and metabolic diseases. Given the pathophysiological mechanisms associated with chronic stress and related cardiovascular and metabolic changes, it is necessary to implement measures to prevent, control and/or avoid their development. Physical exercise is a non-pharmacological resource that is widely used for this purpose. Its beneficial effects include the improvement of the emotional state as well as lipid and glycemic control. Objective: The aim of this review is to discuss the relationship between stress, depression, cardiovascular and metabolic changes, and highlight the importance of physical exercise in the prevention and treatment of resulting disorders. Materials and Methods: We searched MEDLINE and SCIELO from 2000 through 2012, using the terms chronic stress, mood disorders, depression, cardiovascular and metabolic changes, and exercise. Results: Most of the studies found in our literature search have shown that exercise can attenuate and/or reverse the deleterious effects of chronic stress. Conclusion: Regular physical exercise is useful for maintaining health, especially with respect to improving mood and mental stress.

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