Abstract

Objective

Amyotrophic Lateral Sclerosis is one major disease in the group of neurodegenerative conditions. As with most other neurodegenerative diseases, clinical signs of the disease usually show among the elderly population, and most commonly around 60–65 years of age. Therefore the disease is not expected to impact the fertility of ALS patients. When examined from an evolutionary medicine and evolutionary biology perspective, there should be no selection pressure on the patient population due to the late onset of ALS. Methods: In this study, we tested the hypothesis that ALS does not affect fertility on a group of patients with ALS that we collected in a multi-center study. We recruited 511 patients diagnosed with ALS according to the revised El Escorial criteria, and 236 control cases without a neurodegenerative disease. We compared the ALS group’s number of offspring with the control group in three consecutive generations. Results: No statistically significant difference was found between the number of siblings of ALS and control groups (p = 0.44). A statistically significant difference was found between the number of children of ALS and control groups (p < 0.001), indicating ALS patients had more children than controls. When the number of children is assessed by gender, for women, there was no statistically significant difference between the number of children of ALS and control groups (p = 0.067). Conclusions: This finding supports the view that ALS does not have a negative selection pressure on the patient population’s fertility.

中文翻译：

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ALS 和生育能力：ALS 是否会影响患者的孩子数量？

摘要

客观的

肌萎缩侧索硬化症是神经退行性疾病组中的一种主要疾病。与大多数其他神经退行性疾病一样，该疾病的临床症状通常出现在老年人群中，最常见的是 60-65 岁左右。因此，预计该疾病不会影响 ALS 患者的生育能力。从进化医学和进化生物学的角度来看，由于 ALS 发病较晚，不应对患者群体造成选择压力。方法：在这项研究中，我们在一项多中心研究中收集的一组 ALS 患者身上检验了 ALS 不影响生育能力的假设。我们根据修订后的 El Escorial 标准招募了 511 名诊断为 ALS 的患者，以及 236 名没有神经退行性疾病的对照病例。我们连续三代比较了ALS组与对照组的后代数量。结果：ALS 的兄弟姐妹数量与对照组之间无统计学差异（p  = 0.44）。ALS患儿数与对照组差异有统计学意义（p < 0.001)，表明 ALS 患者的孩子多于对照组。当按性别评估儿童数量时，对于女性，ALS 和对照组的儿童数量之间没有统计学上的显着差异（p  = 0.067）。结论：这一发现支持了 ALS 对患者群体的生育能力没有负面选择压力的观点。