Merlino Giovanni, Fratticci Lara, Valente Mariarosaria, Del Giudice Angela, Noacco Claudio, Dolso Pierluigi, Cancelli Iacopo, Scalise Anna, Gigli Gian Luigi
Sleep Disorder Center; Neurology and Clinical Neurophysiology, Santa Maria della Misericordia University Hospital, Udine, Italy.
Sleep. 2007 Jul;30(7):866-71. doi: 10.1093/sleep/30.7.866.
To look for an association between restless legs syndrome (RLS) and type 2 diabetes in a case-control study; to analyze the characteristics of RLS in diabetic patients; and to identify possible risk factors for the development of RLS in diabetic patients.
A case-control study.
Diabetic outpatient clinic of a major university hospital.
One hundred twenty-four consecutive outpatients with diabetes and 87 consecutive controls with a previous diagnosis of other endocrine disease.
RLS was diagnosed using the criteria of the International RLS Study Group, and severity of RLS was assessed using the International RLS Study Group Rating Scale. Characteristics of RLS and several laboratory parameters were investigated in diabetic patients and controls affected by the sleep disorder. A clinical diagnosis of polyneuropathy was assessed to evaluate its role as a risk factor for RLS in diabetic patients.
RLS was diagnosed in 22 diabetic patients (17.7%) and in only 5 controls (5.5%), 3 of whom had pituitary and 2 had adrenal gland disorders, and RLS was independently associated with type 2 diabetes (P < 0.04). Even if a clinical diagnosis of polyneuropathy was made in only 27% of diabetic patients affected by RLS, after multivariate logistic regression, the presence of polyneuropathy was the only variable associated with RLS in diabetics (odds ratio, 7.88; 95% confidence interval, 1.34-46.28; P < 0.02). RLS in diabetics showed a frequency of positive family history lower than that known for primary RLS, showed a late age of onset, and manifested itself after the diagnosis of diabetes was made.
This is the first controlled study confirming a significant association between RLS and type 2 diabetes. In diabetic patients, polyneuropathy represents the main risk factor for RLS. However, polyneuropathy only partially explains the increased prevalence of RLS in type 2 diabetics. Clinical characteristics of RLS in diabetic patients are those of a secondary form.
在一项病例对照研究中寻找不宁腿综合征（RLS）与2型糖尿病之间的关联；分析糖尿病患者中RLS的特征；并确定糖尿病患者发生RLS的可能危险因素。
病例对照研究。
一所大型大学医院的糖尿病门诊。
124例连续就诊的糖尿病门诊患者和87例先前诊断为其他内分泌疾病的连续对照者。
采用国际RLS研究组的标准诊断RLS，并使用国际RLS研究组评分量表评估RLS的严重程度。对受睡眠障碍影响的糖尿病患者和对照者的RLS特征及多项实验室参数进行了调查。评估了多发性神经病的临床诊断，以评估其作为糖尿病患者RLS危险因素的作用。
22例糖尿病患者（17.7%）被诊断为RLS，而对照组中只有5例（5.5%）被诊断为RLS，其中3例患有垂体疾病，2例患有肾上腺疾病，RLS与2型糖尿病独立相关（P<0.04）。即使在受RLS影响的糖尿病患者中，只有27%的患者被临床诊断为多发性神经病，但在多因素逻辑回归分析后，多发性神经病的存在是糖尿病患者中与RLS相关的唯一变量（比值比，7.88；95%置信区间,1.34 - 46.28；P<0.02）。糖尿病患者中的RLS显示出阳性家族史的频率低于原发性RLS，发病年龄较晚，且在糖尿病诊断后才出现。
这是第一项证实RLS与2型糖尿病之间存在显著关联的对照研究。在糖尿病患者中，多发性神经病是RLS的主要危险因素。然而，多发性神经病仅部分解释了2型糖尿病患者中RLS患病率的增加。糖尿病患者中RLS的临床特征为继发性形式。
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