title: Prediagnostic body fat and risk of death from amyotrophic lateral sclerosis: the EPIC cohort.
abstract: OBJECTIVE
  The aim of this study was to investigate for the first time the association between body fat and risk of amyotrophic lateral sclerosis (ALS) with an appropriate prospective study design.
  
  
  METHODS
  The EPIC (European Prospective Investigation into Cancer and Nutrition) study included 518,108 individuals recruited from the general population across 10 Western European countries. At recruitment, information on lifestyle was collected and anthropometric characteristics were measured. Cox hazard models were fitted to investigate the associations between anthropometric measures and ALS mortality.
  
  
  RESULTS
  Two hundred twenty-two ALS deaths (79 men and 143 women) occurred during the follow-up period (mean follow-up = 13 years). There was a statistically significant interaction between categories of body mass index and sex regarding ALS risk (p = 0.009): in men, a significant linear decrease of risk per unit of body mass index was observed (hazard ratio = 0.93, 95% confidence interval 0.86-0.99 per kg/m(2)); among women, the risk was more than 3-fold increased for underweight compared with normal-weight women. Among women, a significant risk reduction increasing the waist/hip ratio was also evident: women in the top quartile had less than half the risk of ALS compared with those in the bottom quartile (hazard ratio = 0.48, 95% confidence interval 0.25-0.93) with a borderline significant p value for trend across quartiles (p = 0.056).
  
  
  CONCLUSIONS
  Increased prediagnostic body fat is associated with a decreased risk of ALS mortality.
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK. v.gallo@imperial.ac.uk
authors: Valentina
authors: V
authors: Gallo
authors: Petra A
authors: PA
authors: Wark
authors: Mazda
authors: M
authors: Jenab
authors: Neil
authors: N
authors: Pearce
authors: Carol
authors: C
authors: Brayne
authors: Roel
authors: R
authors: Vermeulen
authors: Peter M
authors: PM
authors: Andersen
authors: Goran
authors: G
authors: Hallmans
authors: Andreas
authors: A
authors: Kyrozis
authors: Nicola
authors: N
authors: Vanacore
authors: Mariam
authors: M
authors: Vahdaninia
authors: Verena
authors: V
authors: Grote
authors: Rudolf
authors: R
authors: Kaaks
authors: Amalia
authors: A
authors: Mattiello
authors: H Bas
authors: HB
authors: Bueno-de-Mesquita
authors: Petra H
authors: PH
authors: Peeters
authors: Ruth C
authors: RC
authors: Travis
authors: Jesper
authors: J
authors: Petersson
authors: Oskar
authors: O
authors: Hansson
authors: Larraitz
authors: L
authors: Arriola
authors: Juan-Manuel
authors: JM
authors: Jimenez-Martin
authors: Anne
authors: A
authors: Tjønneland
authors: Jytte
authors: J
authors: Halkjær
authors: Claudia
authors: C
authors: Agnoli
authors: Carlotta
authors: C
authors: Sacerdote
authors: Catalina
authors: C
authors: Bonet
authors: Antonia
authors: A
authors: Trichopoulou
authors: Diana
authors: D
authors: Gavrila
authors: Kim
authors: K
authors: Overvad
authors: Elisabete
authors: E
authors: Weiderpass
authors: Domenico
authors: D
authors: Palli
authors: J Ramón
authors: JR
authors: Quirós
authors: Rosario
authors: R
authors: Tumino
authors: Kay-Tee
authors: KT
authors: Khaw
authors: Nicholas
authors: N
authors: Wareham
authors: Aurelio
authors: A
authors: Barricante-Gurrea
authors: Veronika
authors: V
authors: Fedirko
authors: Pietro
authors: P
authors: Ferrari
authors: Françoise
authors: F
authors: Clavel-Chapelon
authors: Marie-Christine
authors: MC
authors: Boutron-Ruault
authors: Heiner
authors: H
authors: Boeing
authors: Matthaeus
authors: M
authors: Vigl
authors: Lefkos
authors: L
authors: Middleton
authors: Elio
authors: E
authors: Riboli
authors: Paolo
authors: P
authors: Vineis
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors
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