Abstract
Objectives Metabolic dysfunction is increasingly recognised to be important in the pathogenesis of Motor Neuron Disease(MND). Little is known about the pre-morbid prevalence of metabolic syndrome(MetS) in MND and its effect on the survival. We reviewed the clinical features and reported the baseline prevalence of MetS and its impact on survival in MND patients. We also studied the difference with respect to ethnicity.
Methods We undertook a retrospective study of MND patients registered at Waikato Hospital, New Zealand, between 2013–2020. We collected various demographic and clinical data. Survival analysis was performed using the Kaplan-Meier and Cox proportional-hazards model.
Results We enrolled 106 MND patients, of which 97% had sporadic MND. The mean age at onset was 64.6 years. The male-to-female ratio was 1.65. 82% were Europeans, 10.4% were Māori and 7.6% others. The mean survival from onset was 53.6months. Overall, 32.7% of patients had MetS at baseline. Moreover, those with MetS had significantly reduced survival than those without; 38.4months versus 61.3months respectively(p=0.044). MetS was consistently associated with worse survival, even after adjustment for age, gender, and ethnicity, HR 1.68(p=0.041). Māori patients were more likely to be younger, male, and have primary lateral sclerosis(PLS) and progressive muscular atrophy(PMA), resulting in a trend towards better survival than Europeans.
Conclusion The prevalence of pre-morbid MetS was increased among MND patients. Furthermore, MetS was associated with worse survival. Our study strengthens the view that metabolic dysfunction is a key factor in MND pathogenesis and suggests that MetS should be further studied as a potential risk and prognostic factor.
