Time-trend evolution and determinants of sex ratio in Amyotrophic Lateral Sclerosis.

Benoît Marin (1, 2, 3) , Giancarlo Logroscino (4) , Simona Arcuti (4) , Massimiliano Copetti (5) , Philippe Couratier (6, 3) , Farid Boumédiène (3, 7) , Pierre-Marie Preux (2, 1, 3) , Ettore Beghi (8)

1 Laboratoire de Biostatistique et d'Informatique Médicale
2 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]
3 NET - Neuroépidémiologie Tropicale
4 UNIBA - Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro
5 Statistic Unit
6 Service de Neurologie [CHU Limoges]
7 GEOLAB - Laboratoire de Géographie Physique et Environnementale
8 Laboratory of Neurologic Diseases, Mario Negri Institute, Milan

Objective: To assess time-trend evolution and determinants of sex ratio (SR) in Amyotrophic Lateral Sclerosis (ALS). Background: ALS is a rare neurodegenerative disorder, whose SR is a controversial issue. Non population-based studies published before 1990 reported SR of 2:1 while more recent European or US population-based studies reported a change in the SR that is now approaching 1:1. This evolution could be artifactual (e.g. related to a better ascertainment of women ALS cases in recent time periods) or explained by real increase of ALS incidence for women (related to a change in the gender prevalence of exposure to risk factors). A systematic approach of this issue focusing on population-based studies of ALS is mandatory to get closer to the real pattern of SR in ALS. Methods: We performed a systematic review and meta-analysis of data concerning sex ratio of ALS in population of European ancestral origin (Europe, Northern America, New-Zealand). Only population-based investigations were included. Random effect meta-analysis and meta-regression were performed. We investigated the following study level covariates: sub-continent, time period of the study, latitude, SR and life expectancy in the population under-surveillance, type of design, methods for ALS diagnosis. Results: Among 3085 records, 33 studies were selected (22 from Europe, 10 from Northern America and 1 from New-Zealand). The overall pooled SR of ALS was at 1.21 (95[percnt]CI 1.11-1.31). We investigated the evolution of SR with time, overall and in each subcontinent. Variability of SR was investigated, considering each of the above defined study level covariates as potential sources of heterogeneity. Discussion: This review will help to clarify the real pattern of SR in ALS, potential evolution and drivers. Disclosure: Dr. Marin has nothing to disclose. Dr. Logroscino has received personal compensation in an editorial capacity for Karger. Dr. Arcuti has nothing to disclose. Dr. Copetti has nothing to disclose. Dr. Couratier has nothing to disclose. Dr. Boumediene has nothing to disclose. Dr. Preux has nothing to disclose. Dr. Beghi has received personal compensation for activities with UCB-Pharma, Shire as an advisory board membe

Domaines: Santé publique et épidémiologie

Benoît Marin, Giancarlo Logroscino, Simona Arcuti, Massimiliano Copetti, Philippe Couratier, et al.. Time-trend evolution and determinants of sex ratio in Amyotrophic Lateral Sclerosis.. AAN 68th Annual Meeting, Apr 2016, Vancouver, Canada. Sup. P5.092. ⟨hal-01340270⟩