Risk of amyotrophic lateral sclerosis and other motor neuron disease among men with benign prostatic hyperplasia

A population-based cohort study

Trine Toft Sørensen, E. Puhó, Mette Nørgaard, Vera Ehrenstein, Victor W. Henderson

Research output: Contribution to journalArticle

Abstract

Objectives Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder. Sleep disturbance may interfere with clearance of abnormal proteins that aggregate in neurodegenerative diseases. The objective of this study was to examine the association between benign prostatic hyperplasia (BPH), a common disorder causing nocturia and sleep disturbance, and risk of ALS and other motor neuron disease (MND). We hypothesised that men with BPH, in comparison to men in the general population, would be at increased risk. Design This is a nationwide, population-based cohort study. Setting This study was conducted among the population of Denmark. Participants We used linked Danish medical databases to identify all men with a first-time diagnosis of BPH between 1 January 1980 and 30 November 2013 and no prior diagnosis of MND (BPH cohort, n=223 131) and an age-matched general population comparison cohort of men without BPH or MND (n=1 115 642). Primary outcome measure The primary outcome is diagnosis of MND after the BPH diagnosis (index) date, with follow-up until MND diagnosis, emigration, death or 30 November 2013. Results We used Cox regression to compute adjusted HR, comparing men with and without BPH. After 34 years of follow-up, there were 227 cases of MND in the BPH cohort (incidence rate 0.13/1000 person-years) and 1094 MND cases in the comparison cohort (0.12/1000 person-years; HR 1.05, 95% CI 0.90 to 1.22). Risk did not vary by follow-up time. Conclusions BPH is not associated with an increased risk of ALS and other MND. Future studies should examine the relation between other disorders that disrupt sleep and MND risk in men and women.

Original languageEnglish
Article numbere030015
JournalBMJ open
Volume9
Issue number7
DOIs
Publication statusPublished - Jul 1 2019

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Amyotrophic Lateral Sclerosis
Prostatic Hyperplasia
Motor Neuron Disease
Cohort Studies
Population
Neurodegenerative Diseases
Sleep
Nocturia
Emigration and Immigration
Denmark
Outcome Assessment (Health Care)
Databases
Incidence

Keywords

  • amyotrophic lateral sclerosis
  • benign prostatic hyperplasia
  • motor neurone disease
  • sleep disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk of amyotrophic lateral sclerosis and other motor neuron disease among men with benign prostatic hyperplasia : A population-based cohort study. / Sørensen, Trine Toft; Puhó, E.; Nørgaard, Mette; Ehrenstein, Vera; Henderson, Victor W.

In: BMJ open, Vol. 9, No. 7, e030015, 01.07.2019.

Research output: Contribution to journalArticle

Sørensen, Trine Toft ; Puhó, E. ; Nørgaard, Mette ; Ehrenstein, Vera ; Henderson, Victor W. / Risk of amyotrophic lateral sclerosis and other motor neuron disease among men with benign prostatic hyperplasia : A population-based cohort study. In: BMJ open. 2019 ; Vol. 9, No. 7.
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abstract = "Objectives Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder. Sleep disturbance may interfere with clearance of abnormal proteins that aggregate in neurodegenerative diseases. The objective of this study was to examine the association between benign prostatic hyperplasia (BPH), a common disorder causing nocturia and sleep disturbance, and risk of ALS and other motor neuron disease (MND). We hypothesised that men with BPH, in comparison to men in the general population, would be at increased risk. Design This is a nationwide, population-based cohort study. Setting This study was conducted among the population of Denmark. Participants We used linked Danish medical databases to identify all men with a first-time diagnosis of BPH between 1 January 1980 and 30 November 2013 and no prior diagnosis of MND (BPH cohort, n=223 131) and an age-matched general population comparison cohort of men without BPH or MND (n=1 115 642). Primary outcome measure The primary outcome is diagnosis of MND after the BPH diagnosis (index) date, with follow-up until MND diagnosis, emigration, death or 30 November 2013. Results We used Cox regression to compute adjusted HR, comparing men with and without BPH. After 34 years of follow-up, there were 227 cases of MND in the BPH cohort (incidence rate 0.13/1000 person-years) and 1094 MND cases in the comparison cohort (0.12/1000 person-years; HR 1.05, 95{\%} CI 0.90 to 1.22). Risk did not vary by follow-up time. Conclusions BPH is not associated with an increased risk of ALS and other MND. Future studies should examine the relation between other disorders that disrupt sleep and MND risk in men and women.",
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N2 - Objectives Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder. Sleep disturbance may interfere with clearance of abnormal proteins that aggregate in neurodegenerative diseases. The objective of this study was to examine the association between benign prostatic hyperplasia (BPH), a common disorder causing nocturia and sleep disturbance, and risk of ALS and other motor neuron disease (MND). We hypothesised that men with BPH, in comparison to men in the general population, would be at increased risk. Design This is a nationwide, population-based cohort study. Setting This study was conducted among the population of Denmark. Participants We used linked Danish medical databases to identify all men with a first-time diagnosis of BPH between 1 January 1980 and 30 November 2013 and no prior diagnosis of MND (BPH cohort, n=223 131) and an age-matched general population comparison cohort of men without BPH or MND (n=1 115 642). Primary outcome measure The primary outcome is diagnosis of MND after the BPH diagnosis (index) date, with follow-up until MND diagnosis, emigration, death or 30 November 2013. Results We used Cox regression to compute adjusted HR, comparing men with and without BPH. After 34 years of follow-up, there were 227 cases of MND in the BPH cohort (incidence rate 0.13/1000 person-years) and 1094 MND cases in the comparison cohort (0.12/1000 person-years; HR 1.05, 95% CI 0.90 to 1.22). Risk did not vary by follow-up time. Conclusions BPH is not associated with an increased risk of ALS and other MND. Future studies should examine the relation between other disorders that disrupt sleep and MND risk in men and women.

AB - Objectives Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder. Sleep disturbance may interfere with clearance of abnormal proteins that aggregate in neurodegenerative diseases. The objective of this study was to examine the association between benign prostatic hyperplasia (BPH), a common disorder causing nocturia and sleep disturbance, and risk of ALS and other motor neuron disease (MND). We hypothesised that men with BPH, in comparison to men in the general population, would be at increased risk. Design This is a nationwide, population-based cohort study. Setting This study was conducted among the population of Denmark. Participants We used linked Danish medical databases to identify all men with a first-time diagnosis of BPH between 1 January 1980 and 30 November 2013 and no prior diagnosis of MND (BPH cohort, n=223 131) and an age-matched general population comparison cohort of men without BPH or MND (n=1 115 642). Primary outcome measure The primary outcome is diagnosis of MND after the BPH diagnosis (index) date, with follow-up until MND diagnosis, emigration, death or 30 November 2013. Results We used Cox regression to compute adjusted HR, comparing men with and without BPH. After 34 years of follow-up, there were 227 cases of MND in the BPH cohort (incidence rate 0.13/1000 person-years) and 1094 MND cases in the comparison cohort (0.12/1000 person-years; HR 1.05, 95% CI 0.90 to 1.22). Risk did not vary by follow-up time. Conclusions BPH is not associated with an increased risk of ALS and other MND. Future studies should examine the relation between other disorders that disrupt sleep and MND risk in men and women.

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