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Artículo

Exposure to endogenous and exogenous sex hormones and reproductive history influence prognosis in women with ALS

Gonzalez Deniselle, Maria ClaudiaIcon ; Bettini, Mariela; Garrido, Rosa M.; Meyer, MariaIcon ; Lara, Agustina Belen; Garay, Laura InesIcon ; Casas, Sebastián MarceloIcon ; Fulgenzi, Ernesto; Nuñez, Myriam; Rugiero, Marcelo F.; de Nicola, Alejandro FedericoIcon ; Gargiulo Monachelli, Gisella MarianaIcon
Fecha de publicación: 07/2023
Editorial: John Wiley & Sons
Revista: Muscle & Nerve
ISSN: 0148-639X
e-ISSN: 1097-4598
Idioma: Inglés
Tipo de recurso: Artículo publicado
Clasificación temática:
Neurología Clínica

Resumen

Introduction/aims: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a higher incidence in men suggesting an influence of sex steroids. Our objective was to investigate past exposure to endogenous and synthetic steroids in female ALS patients and controls.Methods: We administered a questionnaire to 158 postmenopausal women (75 ALS patients and 83 controls). We calculated reproductive time span (RTS), lifetime endogenous estrogen (LEE) and progesterone exposures (LPE), oral contraceptive pill (OCP) use, and reproductive history.Results: ALS patients showed shorter LEE and LPE, a lower proportion of breast cancer, and 11% showed no history of pregnancies vs. 4% of controls. Odds ratios (ORs) showed that <17 y of LEE and a delayed menarche (>13 y) constitute risk factors for ALS [OR = 2.1 (95% confidence interval {CI}, 1.08-4.2); and OR = 2.4 (95% CI, 1.1-5.1) respectively]. According to Cox survival analysis, for each year the LEE increased over 17 y, it was independently associated with longer survival [hazard ratio (HR) = 0.37 (95% CI, 0.16-0.85)] after adjusting for smoking, age and site of onset. Multivariate regression analysis demonstrated that for each month using OCP for longer than 40 mo increased the risk of ALS [adjusted OR = 4.1 (95% CI, 1.2-13.8)].Discussion: Thus, longer exposure to endogenous female sex steroids increased survival and reduced ALS susceptibility. In contrast, longer exposure to synthetic sex steroids showed a negative impact by reducing the production of endogenous female sex steroids or due to crossover with other steroid receptors. Given the neuroprotective effects of sex steroids, we suggest that abnormalities of neuroendocrine components may alter motor function in women with ALS.
Palabras clave: Age of menarche , Amyotrophic lateral sclerosis , Sex steroids , Survival
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info:eu-repo/semantics/restrictedAccess Excepto donde se diga explícitamente, este item se publica bajo la siguiente descripción: Creative Commons Attribution-NonCommercial-ShareAlike 2.5 Unported (CC BY-NC-SA 2.5)
Identificadores
URI: http://hdl.handle.net/11336/250317
URL: https://onlinelibrary.wiley.com/doi/10.1002/mus.27942
DOI: http://dx.doi.org/10.1002/mus.27942
Colecciones
Articulos(CEMIC-CONICET)
Articulos de CENTRO DE EDUCACION MEDICA E INVESTIGACIONES CLINICAS "NORBERTO QUIRNO"
Articulos(IBYME)
Articulos de INST.DE BIOLOGIA Y MEDICINA EXPERIMENTAL (I)
Citación
Gonzalez Deniselle, Maria Claudia; Bettini, Mariela; Garrido, Rosa M.; Meyer, Maria; Lara, Agustina Belen; et al.; Exposure to endogenous and exogenous sex hormones and reproductive history influence prognosis in women with ALS; John Wiley & Sons; Muscle & Nerve; 68; 4; 7-2023; 414-421
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