Neurology :锻炼身体,或不影响渐冻症进展

2021-10-23 Freeman MedSci原创

PA水平与ALS病例的生存有很强的非线性关系,中度PA的生存最好

剧烈运动(PA)作为肌萎缩性脊髓侧索硬化症(ALS)的风险因素的概念在1962年首次被提及,后来被几个著名的运动员如Lou Gehrig和意大利足球运动员在职业运动期间做了大量运动后患上ALS的故事所支持。

此后,一些队列研究发现意大利和美国的足球和橄榄球运动员有患ALS的风险。

进一步暗示(剧烈的)PA可能是ALS的风险因素来自于包括大量接触工作相关和体育相关的体育锻炼的病人的研究。

另一方面,一些研究报告了剧烈运动对ALS风险没有影响或甚至有保护作用。

有趣的是,在一项包括英国近70万患者的大型研究中,没有冠心病(意味着血管健康)的患者与帕金森病或多发性硬化症相比,患ALS的风险略有增加。病例对照研究并没有显示出关于PA作为ALS风险因素的一致结果。这可能是由于测量生命期暴露的方法上的困难。暴露的时间和强度可能与关联的方向和强度有关。


藉此,德国Ulm University的Angela Rosenbohm等人,在一项基于人口的病例对照研究中,检查自我报告的休闲和工作相关的PA与ALS风险之间的关系,并调查ALS病例队列中招募时和一生中PA的预后价值。

他们通过对工作和休闲时间的调查问卷收集的终生PA值被量化为代谢当量(MET)。在斯瓦比亚ALS登记处进行了一项基于人口的病例对照研究,以计算不同时间间隔和预后的ALS的PA的赔率(OR)。

在ALS病例中(393例,791例年龄和性别匹配的对照组),他们观察到与对照组相比,访谈时和访谈前5年的总PA减少。

在随访前5-55年,总PA与ALS的风险没有关系。繁重的职业工作强度与ALS风险增加有关(OR=1.97,95%-CI(1.34,2.89))。

总的PA水平以非线性方式与生存相关:不活动的患者和最高活动水平(25 METh/week)显示出最差的生存时间,分别为15.4/19.3个月。在调整了其他预后因素后,10.5 METh/week的中位生存期最好,为29.8个月。

与对照组相比,终生综合PA在疾病发生前几年急剧下降。患ALS的风险与访谈前5-55年的总PA水平无关,与职业性PA相反,可能反映了与工作有关的暴露。

目前和诊断前的PA水平与ALS病例的生存有很强的非线性关系,中度PA的生存最好。PA强度可能是一个疾病改变因素,对久坐和多动的行为有不利的结果。



原文出处:
Rosenbohm A, Peter R, Dorst J, et al. Life Course of Physical Activity and Risk and Prognosis of Amyotrophic Lateral Sclerosis in a German ALS Registry. Neurology. Published online October 20, 2021:10.1212/WNL.0000000000012829. doi:10.1212/WNL.0000000000012829

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    2022-09-25 小小医者

    #锻炼#身体,或不影响#渐冻症#进展

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    2021-12-31 yinhl1978
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    2021-10-25 xjy02
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    2021-10-24 ms9000000212834100

    剧烈运动(PA)作为肌萎缩性脊髓侧索硬化症(ALS)的风险因素的概念在1962年首次被提及,后来被几个著名的运动员如Lou Gehrig和意大利足球运动员在职业运动期间做了大量运动后患上ALS的故事所支持。

    0

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