Incidence of and Mortality From Amyotrophic Lateral Sclerosis in National Football League Athletes.
Incidence of and Mortality From Amyotrophic Lateral Sclerosis in National Football League Athletes.
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DOI：
10.1001/jamanetworkopen.2021.38801
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发表时间：
2021-12-01
影响因子：
13.8
通讯作者：
McKee AC
中科院分区：
文献类型：
--
作者：
Daneshvar DH;Mez J;Alosco ML;Baucom ZH;Mahar I;Baugh CM;Valle JP;Weuve J;Paganoni S;Cantu RC;Zafonte RD;Stern RA;Stein TD;Tripodis Y;Nowinski CJ;McKee AC
美国国家橄榄球联盟（NFL）运动员中肌萎缩侧索硬化症（ALS）的发病率和死亡率是多少？
在这项对1960年至2019年间首次亮相且至少参加过1场职业比赛的所有19423名NFL运动员进行的队列研究中，在考虑年龄和种族因素后，这些运动员的ALS发病率和死亡率几乎是美国男性人口的4倍。在这些运动员中，被诊断患有ALS的运动员比未患ALS的运动员参加橄榄球运动的时间大约长2.5年。
这项研究的结果表明，与参加NFL相关的因素可能会增加ALS的发病率和死亡率。
肌萎缩侧索硬化症（ALS）是一种致命的神经退行性疾病；了解ALS的风险因素是一个关键的公共卫生问题。
评估美国国家橄榄球联盟（NFL）运动员中肌萎缩侧索硬化症（ALS）的发病率和死亡率，并描述该队列中与ALS相关的特征。
这项基于人群的队列研究包括1960年至2019年间首次亮相且参加过1场或多场职业比赛的所有19423名NFL运动员。研究于2020年10月3日至2021年7月19日进行。
参加NFL，包括参加1场或多场职业比赛。
ALS病例和死亡信息是根据NFL统计汇总机构的公共记录、新闻报道、讣告以及国家死亡索引结果确定的。标准化发病率比和标准化死亡率比是根据从考虑年龄、性别和种族的ALS监测研究中获取的数据计算得出的。二次分析采用巢式病例对照设计，根据NFL首次亮相年份将患有ALS的运动员与未患ALS的运动员进行匹配，检验了体重指数、NFL职业生涯时长、种族、出生地以及知名度指标之间的关联。
这项队列研究共纳入19423名男性前NFL球员和现役NFL球员（年龄范围为23 - 78岁），累计随访493168年（平均[标准差]随访时间为30.6[13.7]年）。在研究期间，有38名球员被诊断患有ALS，28人死亡，这表明在考虑年龄和种族因素后，NFL球员中ALS的诊断发病率（标准化发病率比为3.59；95%置信区间为2.58 - 4.93）和死亡率（标准化死亡率比为3.94；95%置信区间为2.62 - 5.69）显著高于美国男性人口。在NFL运动员中，巢式病例对照分析发现，被诊断患有ALS的运动员的职业生涯（平均[标准差]时长为7.0[3.9]年）明显长于未患ALS的运动员（平均[标准差]时长为4.5[3.6]年；优势比为1.2；95%置信区间为1.1 - 1.3）。根据NFL知名度、体重指数、所打位置、出生地或种族等指标，ALS患病情况没有差异。
1960年至2019年间首次亮相的所有NFL球员中，经年龄、性别和种族调整后的ALS发病率和死亡率几乎是普通人群的4倍。被诊断患有ALS的运动员的NFL职业生涯比未患ALS的运动员更长，这表明NFL比赛时长与ALS之间存在关联。这些ALS风险因素的确定有助于为研究这种致命神经退行性疾病的病理生理机制提供信息。
这项队列研究评估了1960年至2019年间美国国家橄榄球联盟（NFL）运动员中肌萎缩侧索硬化症（ALS）的发病率和死亡率，并描述了该队列中与ALS相关的特征。
What are the incidence and mortality rates of amyotrophic lateral sclerosis (ALS) in athletes who played in the National Football League (NFL)? In this cohort study of all 19 423 NFL athletes who debuted between 1960 and 2019 and played at least 1 professional game, the athletes had nearly 4 times higher incidence and mortality rates of ALS compared with the US male population, adjusting for age and race. Among these athletes, those with a diagnosis of ALS had played football for approximately 2.5 years longer than those without ALS. This study’s findings suggest that factors associated with NFL participation may increase the incidence of and mortality from ALS. Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease; understanding ALS risk factors is a critical public health issue. To evaluate the incidence of and mortality from ALS in National Football League (NFL) athletes and to describe characteristics associated with ALS within this cohort. This population-based cohort study included all 19 423 NFL athletes who debuted between 1960 and 2019 and played 1 or more professional game. It was conducted between October 3, 2020, and July 19, 2021. Participation in the NFL, including playing 1 or more professional games. Cases of ALS and death information were identified based on public records from NFL statistics aggregators, news reports, obituaries, and National Death Index results. The standardized incidence ratio and the standardized mortality ratio were calculated based on data acquired from surveillance studies of ALS accounting for age, sex, and race. Secondary analyses examined the association of body mass index, NFL career duration, race, birth location, and markers of fame, using a nested case-control design, matching athletes with ALS to athletes without ALS, by NFL debut year. A total of 19 423 male former and current NFL players (age range, 23-78 years) were included in this cohort study and were followed up for a cumulative 493 168 years (mean [SD] follow-up, 30.6 [13.7] years). Thirty-eight players received a diagnosis of ALS, and 28 died during the study time frame, representing a significantly higher incidence of ALS diagnosis (standardized incidence ratio, 3.59; 95% CI, 2.58-4.93) and mortality (standardized mortality ratio, 3.94; 95% CI, 2.62-5.69) among NFL players compared with the US male population, adjusting for age and race. Among NFL athletes, nested-case-control analyses found that those who received a diagnosis of ALS had significantly longer careers (mean [SD] duration, 7.0 [3.9] years) than athletes without ALS (mean [SD] duration, 4.5 [3.6] years; odds ratio, 1.2; 95% CI, 1.1-1.3). There were no differences in ALS status based on proxies of NFL fame, body mass index, position played, birth location, or race. The age-, sex-, and race-adjusted incidence of and mortality from ALS among all NFL players who debuted between 1960 and 2019 were nearly 4 times as high as those of the general population. Athletes with a diagnosis of ALS had longer NFL careers than those without ALS, suggesting an association between NFL duration of play and ALS. The identification of these risk factors for ALS helps to inform the study of pathophysiological mechanisms responsible for this fatal neurodegenerative disease. This cohort study evaluates the incidence of and mortality from amyotrophic lateral sclerosis (ALS) in National Football League (NFL) athletes from 1960 to 2019 and describes characteristics associated with ALS within this cohort.
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DOI：
10.1097/nen.0b013e3181ee7d85
发表时间：
2010-09
影响因子：
3.2
作者：
McKee AC;Gavett BE;Stern RA;Nowinski CJ;Cantu RC;Kowall NW;Perl DP;Hedley-Whyte ET;Price B;Sullivan C;Morin P;Lee HS;Kubilus CA;Daneshvar DH;Wulff M;Budson AE
通讯作者：
Budson AE
影响因子：
11.2
作者：
Alosco ML;Mez J;Tripodis Y;Kiernan PT;Abdolmohammadi B;Murphy L;Kowall NW;Stein TD;Huber BR;Goldstein LE;Cantu RC;Katz DI;Chaisson CE;Martin B;Solomon TM;McClean MD;Daneshvar DH;Nowinski CJ;Stern RA;McKee AC
通讯作者：
McKee AC
影响因子：
2
作者：
Daneshvar, Daniel H.;Baugh, Christine M.;Cantu, Robert C.
通讯作者：
Cantu, Robert C.
影响因子：
6.8
作者：
Alosco ML;Kasimis AB;Stamm JM;Chua AS;Baugh CM;Daneshvar DH;Robbins CA;Mariani M;Hayden J;Conneely S;Au R;Torres A;McClean MD;McKee AC;Cantu RC;Mez J;Nowinski CJ;Martin BM;Chaisson CE;Tripodis Y;Stern RA
通讯作者：
Stern RA
影响因子：
14.5
作者：
McKee, Ann C.;Stein, Thor D.;Cantu, Robert C.
通讯作者：
Cantu, Robert C.