Frauscher Birgit, Gschliesser Viola, Brandauer Elisabeth, El-Demerdash Essam, Kaneider Matthias, Rücker Lukas, Poewe Werner, Högl Birgit
Department of Neurology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
Sleep Med. 2009 Jun;10(6):611-5. doi: 10.1016/j.sleep.2008.09.007. Epub 2009 Feb 5.
The aim of the study was to prospectively examine all patients with a diagnosis of RLS consulting a sleep disorders clinic and to assess RLS severity and augmentation and their associations, including ferritin levels.
Patients were stratified into patients with RLS as ancillary diagnosis, RLS sufferers without current augmentation and RLS sufferers with current augmentation. Work-up included RLS severity scales and blood biochemical variables including indices of iron metabolism.
In an 18-month period, 302 patients with RLS (183 women, 119 men; mean age, 59.1+/-13.7 years) were recruited. RLS was considered idiopathic in 291 patients (96.4%). Most patients (240, 79.5%) were RLS sufferers, whereas the remaining 62 (20.5%) had RLS as ancillary diagnosis. Nineteen out of 162 patients treated with dopaminergic agents (11.7%) had current augmentation. Almost one-third of all patients (31.1%) had ferritin levels <50microg/l. Patients with an ancillary diagnosis of RLS had higher ferritin levels than RLS sufferers without current augmentation. The lowest ferritin levels were present in RLS sufferers with current augmentation 132.8+/-98.0microg/l vs. 100.6+/-84.5microg/l vs. 55.8+/-43.6microg/l; p=0.002). Patients with augmentation did not differ from non-augmented patients regarding age, gender, RLS etiology, presence of previous augmentation, or any other documented comorbidity (p>0.05).
The severity spectrum of RLS in this clinical cohort ranged from the ancillary diagnosis of RLS to augmented RLS. There was an inverse correlation between RLS severity and ferritin levels. Patients with current augmentation had the lowest ferritin levels. Our data further strengthen a putative role of low iron stores as a potential aggravator of idiopathic RLS. Moreover, low ferritin might represent a potential biomarker of RLS augmentation under dopaminergic therapy.
本研究旨在对所有诊断为不宁腿综合征（RLS）并前往睡眠障碍门诊就诊的患者进行前瞻性检查，评估RLS的严重程度、症状加重情况及其相关性，包括铁蛋白水平。
患者被分为RLS为辅助诊断的患者、当前无症状加重的RLS患者以及当前有症状加重的RLS患者。检查项目包括RLS严重程度量表和血液生化指标，包括铁代谢指标。
在18个月的时间里，招募了302例RLS患者（183例女性，119例男性；平均年龄59.1±13.7岁）。291例患者（96.4%）的RLS被认为是特发性的。大多数患者（240例，79.5%）为RLS患者，其余62例（20.5%）的RLS为辅助诊断。162例接受多巴胺能药物治疗的患者中有19例（11.7%）当前有症状加重。几乎三分之一的患者（31.1%）铁蛋白水平<50μg/l。RLS为辅助诊断的患者的铁蛋白水平高于当前无症状加重的RLS患者。当前有症状加重的RLS患者的铁蛋白水平最低（132.8±98.0μg/l对100.6±84.5μg/l对55.8±43.6μg/l；p=0.002）。有症状加重的患者与无症状加重的患者在年龄、性别、RLS病因、既往是否有症状加重或任何其他记录在案的合并症方面无差异（p>0.05）。
该临床队列中RLS的严重程度范围从RLS的辅助诊断到症状加重的RLS。RLS严重程度与铁蛋白水平呈负相关。当前有症状加重的患者铁蛋白水平最低。我们的数据进一步强化了低铁储备作为特发性RLS潜在加重因素的假定作用。此外，低铁蛋白可能是多巴胺能治疗下RLS症状加重的潜在生物标志物。
