Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis
Introduction Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting the voluntary motor nervous system. Several observational studies have provided conflicting results regarding the association between smoking and ALS. Therefore, Therefore, our objective...
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| Format: | Article |
| Language: | English |
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European Publishing
2024-01-01
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| Series: | Tobacco Induced Diseases |
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| Online Access: | https://www.tobaccoinduceddiseases.org/Association-of-smoking-with-amyotrophic-lateral-sclerosis-A-systematic-review-and,175731,0,2.html |
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| _version_ | 1832587218338709504 |
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| author | Kihun Kim<sup>+<sup/> Dai Sik Ko<sup>+<sup/> Jin-Woo Kim Dongjun Lee Eunjeong Son Hyun-Woo Kim Tae-Jin Song<sup>+<sup/> Yun Hak Kim |
| author_facet | Kihun Kim<sup>+<sup/> Dai Sik Ko<sup>+<sup/> Jin-Woo Kim Dongjun Lee Eunjeong Son Hyun-Woo Kim Tae-Jin Song<sup>+<sup/> Yun Hak Kim |
| author_sort | Kihun Kim<sup>+<sup/> |
| collection | DOAJ |
| description | Introduction
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting the voluntary motor nervous system. Several observational studies have provided conflicting results regarding the association between smoking and ALS. Therefore, Therefore, our objective was to investigate this association through systematic review, meta-analysis, and dose-response analysis.
Methods
On January 16th, 2023, we initially extracted records from medical databases, which included Medline, Embase, Web of Science, Scopus, and ScienceDirect. We included case-control and cohort studies as eligible studies. Subgroup analyses were performed based on sex, study design, and current smoking. Restricted cubic spline analysis was utilized to assess the dose-response relationship between smoking (pack-year) and ALS.
Results
Twenty-eight case-control and four cohort studies met the inclusion criteria. The unadjusted OR for the overall association between smoking and ALS was 1.14 (95% CI: 1.06-1.22, I2=44%, p<0.001), and the adjusted OR was 1.12 (1.03-1.21, I2=49%, p=0.009). Subgroup analysis revealed a more pronounced association among current smokers, with an unadjusted OR of 1.28 (1.10-1.49, I2=66%, p<0.001) and an adjusted OR of 1.28 (1.10-1.48, I2=58%, p=0.001). In the dose-response analysis, the non-linear model revealed an inverted U-shaped curve.
Conclusions
Our study provides evidence of a positive relationship between smoking and the risk of ALS. To mitigate the risk of developing ALS, discontinuing smoking, which is a modifiable risk factor, may be crucial.
TRIALl REGISTRATION:
The study was registered in PROSPERO.
IDENTIFIER:
CRD42023388822 |
| format | Article |
| id | doaj-art-671552a3525a49deba6746c16536ca3f |
| institution | Kabale University |
| issn | 1617-9625 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | European Publishing |
| record_format | Article |
| series | Tobacco Induced Diseases |
| spelling | doaj-art-671552a3525a49deba6746c16536ca3f2025-01-24T15:26:48ZengEuropean PublishingTobacco Induced Diseases1617-96252024-01-0122January11310.18332/tid/175731175731Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysisKihun Kim<sup>+<sup/>0Dai Sik Ko<sup>+<sup/>1Jin-Woo Kim2Dongjun Lee3Eunjeong Son4Hyun-Woo Kim5Tae-Jin Song<sup>+<sup/>6https://orcid.org/0000-0002-9937-762XYun Hak Kim7https://orcid.org/0000-0002-9796-8266Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of KoreaDivision of Vascular Surgery, Department of General Surgery, Gachon University Gil Medical Center, Incheon, Republic of KoreaDepartment of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University Medical Center, Mokdong Hospital, Republic of KoreaDepartment of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of KoreaDivision of Respiratory and Allergy, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of KoreaDepartment of Neurology, Pusan National University Yangsan Hospital, Yangsan, Republic of KoreaDepartment of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Republic of KoreaDepartment of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of KoreaIntroduction Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting the voluntary motor nervous system. Several observational studies have provided conflicting results regarding the association between smoking and ALS. Therefore, Therefore, our objective was to investigate this association through systematic review, meta-analysis, and dose-response analysis. Methods On January 16th, 2023, we initially extracted records from medical databases, which included Medline, Embase, Web of Science, Scopus, and ScienceDirect. We included case-control and cohort studies as eligible studies. Subgroup analyses were performed based on sex, study design, and current smoking. Restricted cubic spline analysis was utilized to assess the dose-response relationship between smoking (pack-year) and ALS. Results Twenty-eight case-control and four cohort studies met the inclusion criteria. The unadjusted OR for the overall association between smoking and ALS was 1.14 (95% CI: 1.06-1.22, I2=44%, p<0.001), and the adjusted OR was 1.12 (1.03-1.21, I2=49%, p=0.009). Subgroup analysis revealed a more pronounced association among current smokers, with an unadjusted OR of 1.28 (1.10-1.49, I2=66%, p<0.001) and an adjusted OR of 1.28 (1.10-1.48, I2=58%, p=0.001). In the dose-response analysis, the non-linear model revealed an inverted U-shaped curve. Conclusions Our study provides evidence of a positive relationship between smoking and the risk of ALS. To mitigate the risk of developing ALS, discontinuing smoking, which is a modifiable risk factor, may be crucial. TRIALl REGISTRATION: The study was registered in PROSPERO. IDENTIFIER: CRD42023388822https://www.tobaccoinduceddiseases.org/Association-of-smoking-with-amyotrophic-lateral-sclerosis-A-systematic-review-and,175731,0,2.htmlsmokingsystematic reviewmeta-analysisamyotrophic lateral sclerosisdose-response analysis |
| spellingShingle | Kihun Kim<sup>+<sup/> Dai Sik Ko<sup>+<sup/> Jin-Woo Kim Dongjun Lee Eunjeong Son Hyun-Woo Kim Tae-Jin Song<sup>+<sup/> Yun Hak Kim Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis Tobacco Induced Diseases smoking systematic review meta-analysis amyotrophic lateral sclerosis dose-response analysis |
| title | Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis |
| title_full | Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis |
| title_fullStr | Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis |
| title_full_unstemmed | Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis |
| title_short | Association of smoking with amyotrophic lateral sclerosis: A systematic review, and meta-analysis, including dose-response analysis |
| title_sort | association of smoking with amyotrophic lateral sclerosis a systematic review and meta analysis including dose response analysis |
| topic | smoking systematic review meta-analysis amyotrophic lateral sclerosis dose-response analysis |
| url | https://www.tobaccoinduceddiseases.org/Association-of-smoking-with-amyotrophic-lateral-sclerosis-A-systematic-review-and,175731,0,2.html |
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