Additionally, the immune burden plays a crucial role in ALS incidence, as IMD with a heavy immune burden (CRP >= 1.3mg/L) is associated with an increased risk of ALS(HR:1.57, 95%CI: 1.09-2.28, Table 4), whereas IMD with a low immune burden does not influence ALS incidence(HR:1.07, 95%CI: 0.56-2.02, Table 4). Here, CRP is linked to amyotrophic lateral sclerosis.