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Liu F, Wang T, Wang S, Zhao X, Hua Y. The association of platelet to white blood cell ratio with diabetes: a nationwide survey in China. Front Endocrinol (Lausanne) 2024; 15:1418583. [PMID: 38957446 PMCID: PMC11217324 DOI: 10.3389/fendo.2024.1418583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024] Open
Abstract
Background Inflammation is integral to diabetes pathogenesis. The novel hematological inflammatory biomarker, platelet to white blood cell ratio (PWR), is linked with various conditions such as chronic kidney disease and stroke. However, the association of this novel clinical indicator with diabetes still remains unclear, which is investigated in this study. Materials and Methods A total of 10,973 Chinese participants were included and grouped according to the tertiles of PWR (T1, T2, and T3 groups). Diagnosis of prediabetes and diabetes adhered to American Diabetes Association criteria. Binary logistic regression was adopted to assess the relationship between PWR and both diabetes and prediabetes. The dose-response relationship of PWR and diabetes was examined using restricted cubic spline regression. Subgroup and interaction analyses were conducted to investigate potential covariate interactions. Results Individuals with higher PWR had better lifestyles and lipid profiles (all P < 0.05). After adjusting for all the covariates, the T2 group had a 0.83-fold (95% CI: 0.73-0.93, P < 0.01) risk of diabetes and that for the T3 group was 0.68-fold (95% CI: 0.60-0.78. P < 0.001). Dose-response analysis identified non-linear PWR-diabetes associations in the general population and females (both P < 0.05), but absent in males. Participants with prediabetes in the T2 and T3 groups had lower risks of diabetes (OR = 0.80 for the T2 group, P < 0.001 and 0.68 for the T3 group, P < 0.001) in the full models. All the sensitivity analysis support consistent conclusions. Conclusions An increase in PWR significantly correlates with reduced diabetes risks. A non-linear PWR-diabetes relationship exists in the general population and females, but not in males. The correlation between PWR and diabetes indicates that PWR holds potentials in early identification and prevention of diabetes.
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Affiliation(s)
- Fanglin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Tianhong Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Siman Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiumei Zhao
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yusi Hua
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
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Guo B, Liu X, Si Q, Zhang D, Li M, Li X, Zhao Y, Hu F, Zhang M, Liu Y, Hu D. Associations of CBC-Derived inflammatory indicators with sarcopenia and mortality in adults: evidence from Nhanes 1999 ∼ 2006. BMC Geriatr 2024; 24:432. [PMID: 38755603 PMCID: PMC11100216 DOI: 10.1186/s12877-024-05012-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND It has been proposed that inflammation plays a role in the development of sarcopenia. This study aimed to investigate the links of complete blood cell count (CBC) parameters and CBC-derived inflammatory indicators with sarcopenia and mortality. METHODS Data pertaining to sarcopenia were extracted from the 1999-2006 National Health and Nutrition Examination Survey (NHANES), and mortality events were ascertained through the National Death Index up to December 31, 2019. The CBC-derived inflammatory indicators assessed in this study included the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII). The prognostic significance of these CBC-derived inflammatory indicators was evaluated using the random survival forests (RSF) analysis. RESULTS The study encompassed a cohort of 12,689 individuals, among whom 1,725 were diagnosed with sarcopenia. Among individuals with sarcopenia, 782 experienced all-cause mortality, and 195 succumbed to cardiovascular causes. Following adjustment for confounding variables, it was observed that elevated levels of NLR, dNLR, NMLR, SIRI, and SII were associated with an increased prevalence of sarcopenia. Among participants with sarcopenia, those in the highest quartile of NLR (HR = 1.336 [1.095-1.631]), dNLR (HR = 1.274 [1.046-1.550]), MLR (HR = 1.619 [1.290-2.032]), NMLR (HR = 1.390 [1.132-1.707]), and SIRI (HR = 1.501 [1.210-1.862]) exhibited an elevated risk of all-cause mortality compared to those in the lowest quartile of these inflammation-derived indicators. These associations were similarly observed in cardiovascular mortality (HR = 1.874 [1.169-3.003] for MLR, HR = 1.838 [1.175-2.878] for SIRI). The RSF analysis indicated that MLR exhibited the highest predictive power for both all-cause and cardiovascular mortality among individuals with sarcopenia. CONCLUSIONS Our findings underscore the association between CBC-derived inflammatory indicators and mortality in adults with sarcopenia. Of note, MLR emerged as the most robust predictor of all-cause and cardiovascular mortality in this population.
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Affiliation(s)
- Botang Guo
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xinqing Liu
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Qi Si
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Minyao Li
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China.
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Singla N, Inavolu P, Kumar BR, Macherla R, Reddy DN. SARC-F Score: A Quick Bedside Tool to Screen Sarcopenia in Patients With Cirrhosis. J Clin Exp Hepatol 2024; 14:101318. [PMID: 38261819 PMCID: PMC10792645 DOI: 10.1016/j.jceh.2023.101318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/07/2023] [Indexed: 01/25/2024] Open
Abstract
Background Sarcopenia is often ignored in clinical practice despite being an important prognostic marker. SARC-F is a simple bedside score to assess muscle abnormalities in cirrhosis patients. However, there is limited Indian data on the validity of this score. Hence, we aimed to assess the validity of SARC-F score in a tertiary care center. Methods A prospective observational study including consecutive 100 cirrhosis patients attending the gastroenterology outpatient department in Osmania Medical College and Hospital, Hyderabad, India, was conducted from Jan 2018 to Dec 2019. The primary aim was to assess the mean muscle volume loss (MVL) by computed tomography and handgrip (HG) strength for muscle strength decline (MSD) and compare the SARC-F score with standard cut-off values. Results We included 100 cirrhosis patients (mean age: 45 years; males: 86%; child-pugh class B/C: 42/58). Sixty-nine percent of the patients had a SARC-F score of ≥4, whereas MVL and MSD were noted in 62% and 86% patients, respectively. Mid-arm circumference, skin-fold thickness, mid-arm muscle circumference (MAMC), and HG strength were significantly lower in patients with SARC-F score ≥4 than in those with SARC-F score <4 (P < 0.05). The Pearson correlation plot suggested a significant inverse correlation between the SARC-F score and MSD and SARC-F score and MVL. A SARC-F score of ≥4 had a sensitivity and specificity of 80.7% and 50% for MVL and 75.6% and 71.4% for MSD, respectively, whereas it was 83.3% and 52.5% for MSD and MVL combined, respectively. Area under the receiver operating characteristic curve for SARC-F as a predictor of MVL was 0.75 (95% confidence interval: 0.64-0.82; P=<0.001). On multivariate analysis, a high SARC-F score and low MAMC were predictive of MVL in cirrhosis patients. Conclusion SARC-F score has good sensitivity as a bedside screening tool for sarcopenia in patients with cirrhosis. A high SARC-F score and low MAMC indicates the presence of MVL and warrants further evaluation for sarcopenia.
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Affiliation(s)
- Neeraj Singla
- Asian Institute of Gastroenterology, Hyderabad, Telangana, India
| | - Pradev Inavolu
- Asian Institute of Gastroenterology, Hyderabad, Telangana, India
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Huang J, Zhang X, Hong Z, Lin X, Chen F, Lan J, Zhang Z, Deng H. Associations of plasma retinol and α-tocopherol levels with skeletal muscle health in Chinese children. Br J Nutr 2023; 130:2174-2181. [PMID: 37341020 DOI: 10.1017/s0007114523001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Childhood is a critical period for muscle accumulation. Studies in elders have reported that antioxidant vitamins could improve muscle health. However, limited studies have assessed such associations in children. This study included 243 boys and 183 girls. A seventy-nine-item FFQ was used to investigate dietary nutrients intake. Plasma levels of retinol and α-tocopherol were measured using high-performance liquid chromatography with MS. Dual X-ray absorptiometry was used to assess appendicular skeletal muscle mass (ASM) and total body fat. The ASM index (ASMI) and ASMI Z-score were then calculated. Hand grip strength was measured using a Jamar® Plus+ Hand Dynamometer. Fully adjusted multiple linear regression models showed that for each unit increase in plasma retinol content, ASM, ASMI, left HGS and ASMI Z-score increased by 2·43 × 10-3 kg, 1·33 × 10-3 kg/m2, 3·72 × 10-3 kg and 2·45 × 10-3 in girls, respectively (P < 0·001-0·050). ANCOVA revealed a dose-response relationship between tertiles of plasma retinol level and muscle indicators (Ptrend: 0·001-0·007). The percentage differences between the top and bottom tertiles were 8·38 %, 6·26 %, 13·2 %, 12·1 % and 116 % for ASM, ASMI, left HGS, right HGS and ASMI Z-score in girls, respectively (Pdiff: 0·005-0·020). No such associations were observed in boys. Plasma α-tocopherol levels were not correlated with muscle indicators in either sex. In conclusion, high circulating retinol levels are positively associated with muscle mass and strength in school-age girls.
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Affiliation(s)
- Jiapeng Huang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Xuanrui Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Zhen Hong
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Xiaoping Lin
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Fengyan Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Jing Lan
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
| | - Hong Deng
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou510400, People's Republic of China
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Miao T, Yu J, Shen Q, Feng G, Ding H, Gao Y, Shen S, Zang Y, Chen X, Zheng X. Grip strength affects the association between platelet count and disability-free survival: Evidence from the China Health and Retirement Longitudinal Study. Arch Gerontol Geriatr 2023; 112:105026. [PMID: 37062186 DOI: 10.1016/j.archger.2023.105026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/01/2023] [Accepted: 04/10/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND AND AIMS Previous studies found elevated platelet count (PLT), especially long-term persist high or increased PLT was associated with less likelihood disability-free survival (DFS). However, whether grip strength affects the relationship between them is still not elucidated. METHODS A total of 6252 participants were recruited in the analysis based on the China Health and Retirement Longitudinal Study. The primary outcome was DFS, evaluated by a composite endpoint based on the first occurrence of either disability (having difficulty in at least one of the 6 activities of daily living: namely, dressing, bathing, continence, eating, getting into or out of bed, and toileting) or all-cause mortality. RESULTS The association of PLT with primary outcome was significantly modified by grip strength (pinteraction = 0.022). The rates of primary outcome were significantly lower among participants with lower baseline PLT in participants with normal grip strength (multivariable odds ratio [OR], 0.67; 95% confidence interval [CI], 0.54-0.84; ptrend < 0.001), but not in those with low grip strength (multivariable OR, 1.70; 95% CI, 0.88-3.15; ptrend = 0.135), for the lowest quartile vs the highest quartile. Adding baseline PLT (quartiles or continuous) to a model containing conventional risk factors significantly improved risk reclassification for primary outcome among those with normal grip strength (most of p < 0.05). CONCLUSION An inverse dose-response association of PLT with DFS was found among participants with normal grip strength, but not among those with low grip strength. Low grip strength might weaken the benefit of low PLT on DFS among middle-aged and older Chinese.
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Affiliation(s)
- Tongtong Miao
- Department of Pharmacy, Nantong First People's Hospital, Second Affiliated Hospital of Nantong University, 666 Shengli Road, Chongchuan District, Nantong, Jiangsu Province 226006, China
| | - Jia Yu
- Department of Acute Infectious Disease Control and Immunization Program, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu 215000, China
| | - Qian Shen
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu 214023, China
| | - Guijuan Feng
- The First Affiliated Hospital of Kangda College of Nanjing Medical University, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu 222000, China
| | - Huan Ding
- Department of Chronic Infectious Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu 214023, China
| | - Yumeng Gao
- Department of Acute Infectious Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu 214023, China
| | - Suwen Shen
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu 214023, China.
| | - Yuhan Zang
- Department of Health Promotion and Chronic Non-Communicable Disease Control, Wuzhong Center for Disease Control and Prevention, 269 Taihu West Road, Wuzhong District, Suzhou, Jiangsu Province 215000, China.
| | - Xia Chen
- Department of Pharmacy, Nantong First People's Hospital, Second Affiliated Hospital of Nantong University, 666 Shengli Road, Chongchuan District, Nantong, Jiangsu Province 226006, China.
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, 1800 Lihu Road, Binhu District, Wuxi, Jiangsu Province 214122, China.
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Mahmudpour M, Homayoun N, Nabipour I, Kalantar Hormozi MR, Boushehri SN, Larijani B, Ostovar A, Amini A, Marzban M. Association of age-related declined renal function and osteoporosis based on trabecular bone score in Bushehr Elderly Health (BEH) program. BMC Nephrol 2023; 24:224. [PMID: 37507659 PMCID: PMC10375762 DOI: 10.1186/s12882-023-03280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Osteoporosis is a systemic disease characterized by decreased bone strength and an increased risk of fracture in old age. Age and pathologic renal failure are independent risk factors for osteoporosis. However, it is not determined whether age-related decreased renal function, in the context of senescence, can be considered as an independent risk factor for osteoporosis. Therefore, this study was conducted to evaluate the effect of senescence-induced renal failure on bone quality and trabecular bone score. METHODS This study used a cross-sectional design and was carried out based on data collected during the Bushehr Elderly Health (BEH) program, Phase II. A total of 2,125 elderly participants aged over 60 years old entered the study after meeting the inclusion criteria and providing informed consent. They underwent examinations for weight, height, abdominal and hip circumference, as well as blood pressure measurement. All participants also underwent DXA to assess bone mass density (BMD). Trabecular bone score (TBS) was calculated using the DXA apparatus software output. Univariate and adjusted multivariate linear regression analyses were used to evaluate the associations. RESULTS In the univariate linear regression analysis, there was a direct correlation between age-related renal failure and TBS (β = 0.038, p < 0.0001), neck of femur BMD (β = 0.047, p < 0.0001), and lumbar BMD (β = 0.055, p < 0.0001). However, after adjusting for BMI, age, sex, smoking, and physical activity, no significant association was observed for these variables. CONCLUSION It is hypothesized that age-related renal failure cannot be considered as an independent risk factor for osteoporosis in elderly individuals aged over 60 years old.
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Affiliation(s)
- Mehdi Mahmudpour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Narges Homayoun
- Student Research Committee, Bushehr University Of Medical Sciences, Bushehr, Iran
- Department of Internal Medicine, School of Medicine, Bushehr University Of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Saeid Najafpour Boushehri
- Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Science, Bushehr, 7514763448, Iran
| | - Bagher Larijani
- Osteoporosis Research Center. Endocrinology and Metabolism Clinical Sciences Institute. Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center. Endocrinology and Metabolism Clinical Sciences Institute. Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Amini
- Department of Internal Medicine, School of Medicine, Bushehr University Of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Science, Bushehr, 7514763448, Iran.
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
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Anderson G. Amyotrophic Lateral Sclerosis Pathoetiology and Pathophysiology: Roles of Astrocytes, Gut Microbiome, and Muscle Interactions via the Mitochondrial Melatonergic Pathway, with Disruption by Glyphosate-Based Herbicides. Int J Mol Sci 2022; 24:ijms24010587. [PMID: 36614029 PMCID: PMC9820185 DOI: 10.3390/ijms24010587] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
The pathoetiology and pathophysiology of motor neuron loss in amyotrophic lateral sclerosis (ALS) are still to be determined, with only a small percentage of ALS patients having a known genetic risk factor. The article looks to integrate wider bodies of data on the biological underpinnings of ALS, highlighting the integrative role of alterations in the mitochondrial melatonergic pathways and systemic factors regulating this pathway across a number of crucial hubs in ALS pathophysiology, namely glia, gut, and the muscle/neuromuscular junction. It is proposed that suppression of the mitochondrial melatonergic pathway underpins changes in muscle brain-derived neurotrophic factor, and its melatonergic pathway mimic, N-acetylserotonin, leading to a lack of metabolic trophic support at the neuromuscular junction. The attenuation of the melatonergic pathway in astrocytes prevents activation of toll-like receptor agonists-induced pro-inflammatory transcription factors, NF-kB, and yin yang 1, from having a built-in limitation on inflammatory induction that arises from their synchronized induction of melatonin release. Such maintained astrocyte activation, coupled with heightened microglia reactivity, is an important driver of motor neuron susceptibility in ALS. Two important systemic factors, gut dysbiosis/permeability and pineal melatonin mediate many of their beneficial effects via their capacity to upregulate the mitochondrial melatonergic pathway in central and systemic cells. The mitochondrial melatonergic pathway may be seen as a core aspect of cellular function, with its suppression increasing reactive oxygen species (ROS), leading to ROS-induced microRNAs, thereby altering the patterning of genes induced. It is proposed that the increased occupational risk of ALS in farmers, gardeners, and sportsmen and women is intimately linked to exposure, whilst being physically active, to the widely used glyphosate-based herbicides. This has numerous research and treatment implications.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SW1V 1PG, UK
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