Some blood lipid biomarkers linked to cardiovascular disease risk are also associated with a reduced risk of amyotrophic lateral sclerosis, new research has found.
Data from a large epidemiology study was used to try to determine the nature of any relationships between levels of biomarkers associated with cardiovascular disease and subsequent diagnosis of ALS, which is the most common form of motor neurone disease.
Researchers from the Department of Clinical Neurosciences, University of Oxford, say they examined data for 502,409 people who enrolled in the UK Biobank study between March 2006 and October 2010, when aged between 39 and 72 years.
All participants had had blood tests when they enrolled. They were followed for a median of 11.9 years.
The research team looked at the relationship between ALS and baseline blood levels of high and low density lipoprotein (HDL and LDL), total cholesterol, apolipoproteins A1 and B (apoA1 and apoB), triglycerides, glycated haemoglobin A1c (HbA1c) and creatinine.
This observational study also looked at the relationship between ALS and self-reported exercise and body mass index.
Writing in the latest edition of the Journal of Neurology Neurosurgery & Psychiatry, after controlling for age and sex, the authors found that high HDL and apoA1 were associated with a reduced risk of ALS, while high total cholesterol:HDL ratio was associated with an increased risk of ALS.
When the researchers incorporated models with multiple metabolic markers to assess the risk of the condition, they found HDL and apoA1 continued to be associated with a reduced risk of ALS independent of other factors. Lower LDL and apoB levels were also associated with a decreased risk of ALS.
Levels of LDL and apoB were shown to be higher long before diagnosis but lower in people closer to diagnosis. However, the researchers found no such differences with HDL and apoA1 levels.
The authors write: “The persistence of these findings in models controlling for statin use, smoking and vascular disease indicates that the association of lipid levels and ALS is not attributable to a confounding association between lipids, ALS and these factors.”
Although this is an observational study with some limitations, the researchers say: “This study adds to a growing literature documenting differences in the premorbid metabolic profile of those who eventually develop ALS.
“In addition to providing novel insights into pathogenesis, this emphasises the need to consider a broader set of potential pre-symptomatic ALS biomarkers. Such markers might help to target population screening for ALS and also build confidence in future trials of preventative therapy.”
Thompson AG, Talbot K, Turner MR. Higher blood high density lipoprotein and apolipoprotein A1 levels are associated with reduced risk of developing amyotrophic lateral sclerosis. Journal of Neurology Neurosurgery & Psychiatry 13 September 2021
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