Szentkiralyi Andras, Molnar Miklos Zsolt, Czira Maria Eszter, Deak Gyorgy, Lindner Anett Virag, Szeifert Lilla, Torzsa Peter, Vamos Eszter Panna, Zoller Rezso, Mucsi Istvan, Novak Marta
Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
J Psychosom Res. 2009 Aug;67(2):173-80. doi: 10.1016/j.jpsychores.2009.05.004.
Restless legs syndrome (RLS) is reportedly associated with depression. This association may be mediated by both sleep-dependent and sleep-independent mechanisms. Here we analyze the association between RLS and depressive symptoms in patients with chronic kidney disease (CKD). We also assessed whether the relationship is independent of insomnia. In a cross-sectional study, socio-demographic parameters, laboratory data, and medical history were collected from 788 kidney transplant patients and 161 dialyzed patients. Insomnia, depression, and the presence of RLS symptoms were assessed with standard questionnaires. Patients with probable RLS had a higher prevalence of depressive symptoms than those without RLS (56% vs. 22% with vs. without RLS, respectively; P<.001). Patients presenting RLS symptoms had higher Athens Insomnia Scale (AIS) scores than patients without RLS [median AIS score (interquartile range): 7 (6) vs. 3 (4) with vs. without RLS, respectively; P<.001]. The AIS score correlated with the CES-D score (Spearman's rho=0.54, P<.001). In multivariate analysis, the presence of RLS symptoms was independently associated with depressive symptoms (OR=3.96, 95% CI 2.21-7.1, P<.001). This relationship remained significant even after including insomnia in the model (OR=2.9, CI 1.55-5.43, P<.001). The presence of RLS symptoms is associated with depression in patients with CKD. This relationship remained significant even after accounting for insomnia. Sleep-independent mechanisms may also contribute to the association between RLS and depression in patients with CKD.
据报道,不宁腿综合征(RLS)与抑郁症有关。这种关联可能由睡眠依赖和非睡眠依赖机制介导。在此,我们分析了慢性肾脏病(CKD)患者中RLS与抑郁症状之间的关联。我们还评估了这种关系是否独立于失眠。在一项横断面研究中,收集了788例肾移植患者和161例透析患者的社会人口统计学参数、实验室数据和病史。使用标准问卷评估失眠、抑郁和RLS症状的存在情况。可能患有RLS的患者抑郁症状的患病率高于无RLS的患者(分别为56%和22%,有RLS与无RLS;P<0.001)。出现RLS症状的患者雅典失眠量表(AIS)得分高于无RLS的患者[中位数AIS得分(四分位间距):分别为7(6)和3(4),有RLS与无RLS;P<0.001]。AIS得分与CES-D得分相关(斯皮尔曼等级相关系数=0.54,P<0.001)。在多变量分析中,RLS症状的存在与抑郁症状独立相关(比值比=3.96,95%置信区间2.21 - 7.1,P<0.001)。即使在模型中纳入失眠因素后,这种关系仍然显著(比值比=2.9,置信区间1.55 - 5.43,P<0.001)。CKD患者中RLS症状的存在与抑郁症有关。即使在考虑失眠因素后,这种关系仍然显著。非睡眠依赖机制也可能导致CKD患者中RLS与抑郁症之间的关联。