Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players
Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players
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DOI：
10.1093/brain/awh373
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发表时间：
2005-03-01
期刊：
影响因子：
14.5
通讯作者：
Mora, G
中科院分区：
文献类型：
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作者：
Chiò, A;Benzi, G;Mora, G
肌萎缩侧索硬化症(ALS)的病因尚不清楚。肌萎缩侧索硬化症和运动参与之间可能存在联系，但从未得到明确的证明。我们研究了1970年至2001年期间意大利甲级或乙级足球队聘用的7325名男性职业足球运动员的队列。肌萎缩侧索硬化症病例是使用不同的并发来源确定的。计算标准化发病率比(SMR)。在137078人年的随访中，确认了5例肌萎缩侧索硬化症病例(平均发病年龄43.4岁)。3例发生延髓病变，显著多于预期(P=0.003)。由于预期病例数为0.77，因此总体SMR为6.5[95%可信区间(CI)，2.1-15.1]。在49岁以前发病的肌萎缩侧索硬化症患者的SMR显著增加，但对于年龄较大的受试者则不显著。在1980-1989年和1990-2001年期间，肌萎缩侧索硬化症病例显著增加，而1970-1979年期间未发现ALS病例。职业足球活动年限与肌萎缩侧索硬化症发病风险之间存在剂量-反应关系(5年，15.2，95%可信区间，3.1~44.4；小于等于5年，3.5，95%可信区间，0.4~12.7)。我们的发现似乎表明，打职业橄榄球是肌萎缩侧索硬化症的强烈风险因素。
The cause of amyotrophic lateral sclerosis (ALS) is still unknown. A possible relationship between ALS and sport participation has been supposed, but never definitely demonstrated. We studied a cohort of 7325 male professional football players engaged by a football team from the Italian First or Second Division in the period 1970-2001. ALS cases were identified using different concurrent sources. Standardized morbidity ratios (SMRs) were calculated. During the 137 078 person-years of follow-up, five ALS cases were identified (mean age of onset, 43.4 years). Three cases had a bulbar onset, significantly more than expected (P = 0.003). Since the number of expected cases was 0.77, the overall SMR was 6.5 [95% confidence interval (CI), 2.1-15.1]. The SMR was significantly increased for an ALS onset before 49 years, but not for older subjects. A significant increase of the SMR was found in the periods 1980-1989 and 1990-2001, whereas no ALS case was found in the 1970-1979 period. A dose-response relationship between the duration of professional football activity and the risk of ALS was found (>5 years, 15.2, 95% CI, 3.1-44.4; less than or equal to5 years, 3.5, 95% CI, 0.4-12.7). Our findings seem to indicate that playing professional football is a strong risk factor for ALS.