Statins, diabetes mellitus and prognosis of amyotrophic lateral sclerosis: data from 501 patients of a population‐based registry in southwest Germany

Abstract

Background A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS. Methods 501 patients (mean age: 65.2 ± 10.9 years; 58.5% male) from the ALS‐registry Swabia recruited between October 2010 and April 2016 were included in this prospective cohort study. Data were collected using a standardized questionnaire. Results Statin use (n=65) was not associated with overall survival (p=0.62). Age of ALS onset in patients with DM was 4.2 years (95% CI 1.3–7.2 years) later compared to patients without DM (p < 0.01). Overall survival of patients with hight body mass index at study entry (> 27.0 kg/m² = upper quartile, n=127) was prolonged by more than five months compared to patients with low BMI (< 22.0 kg/m² = lower quartile, n=123; p = 0.04). Conclusions This study supports the view that statin use is not associated with overall survival of ALS patients, suggesting that statins are not harmful and should not be discontinued in ALS. Furthermore, the delayed onset of ALS in patients with DM may mirror the potentially protective metabolic profile associated with type II DM. Consistently, this study provided further evidence that high BMI is a positive prognostic factor in ALS.