六氯苯
队列
四分位间距
环境卫生
比例危险模型
危险系数
医学
队列研究
风险评估
污染物
肌萎缩侧索硬化
内科学
置信区间
疾病
生物
生态学
计算机安全
计算机科学
作者
Stephen A. Goutman,Jonathan Boss,Dong Gyu Jang,Bhramar Mukherjee,Rudy J. Richardson,Stuart Batterman,Eva L. Feldman
标识
DOI:10.1136/jnnp-2023-332121
摘要
Background Amyotrophic lateral sclerosis (ALS) is a fatal, progressive neurogenerative disease caused by combined genetic susceptibilities and environmental exposures. Identifying and validating these exposures are of paramount importance to modify disease risk. We previously reported that persistent organic pollutants (POPs) associate with ALS risk and survival and aimed to replicate these findings in a new cohort. Method Participants with and without ALS recruited in Michigan provided plasma samples for POPs analysis by isotope dilution with triple quadrupole mass spectrometry. ORs for risk models and hazard ratios for survival models were calculated for individual POPs. POP mixtures were represented by environmental risk scores (ERS), a summation of total exposures, to evaluate the association with risk (ERS risk ) and survival (ERS survival ). Results Samples from 164 ALS and 105 control participants were analysed. Several individual POPs significantly associated with ALS, including 8 of 22 polychlorinated biphenyls and 7 of 10 organochlorine pesticides (OCPs). ALS risk was most strongly represented by the mixture effects of OCPs alpha-hexachlorocyclohexane, hexachlorobenzene, trans -nonachlor and cis -nonachlor and an interquartile increase in ERS risk enhanced ALS risk 2.58 times (p<0.001). ALS survival was represented by the combined mixture of all POPs and an interquartile increase in ERS survival enhanced ALS mortality rate 1.65 times (p=0.008). Conclusions These data continue to support POPs as important factors for ALS risk and progression and replicate findings in a new cohort. The assessments of POPs in non-Michigan ALS cohorts are encouraged to better understand the global effect and the need for targeted disease risk reduction strategies.
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