Cox regression analyses, stratified by baseline age (in 5-year intervals), sex, and center, identified only the SECTM1 protein as significantly associated with ALS risk over 5–30 years of follow-up (hazard ratio [HR]=1.35 per standard deviation [SD] increase in log10 protein levels, p=1.38×10−6) at a false-discovery rate (FDR) control of 0.05. This evidence concerns the gene SECTM1 and amyotrophic lateral sclerosis.