Sleep Laboratory, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
Mov Disord. 2010 Jun 15;25(8):1047-52. doi: 10.1002/mds.23026.
Epidemiological studies consistently point to a relationship between restless legs syndrome (RLS) and cardiovascular disease. The mechanism underlying this association is unclear. Activation of the hypothalamic-pituitary-adrenal (HPA) system has been shown to contribute to the metabolic syndrome and an enhanced cardiovascular risk. We investigated cortisol levels as an indicator of HPA system activity in RLS during the nighttime, when RLS symptoms are at their maximum. We assessed nocturnal urinary cortisol excretion in 73 patients with RLS and 34 healthy controls, controlling for age and gender. Urine sampling was paralleled by polysomnographic recordings. We found significantly enhanced nocturnal cortisol excretion in RLS, demonstrating nocturnal HPA system overactivity in RLS. HPA system overactivity is a possible mechanism contributing to the enhanced load of cardiovascular disease in RLS patients. Nocturnal cortisol release showed weak correlations with some polysomnographic parameters of disturbed sleep, making a potential contribution of RLS-induced sleep disruption to HPA system activation conceivable.
流行病学研究一直指出不宁腿综合征（RLS）与心血管疾病之间存在关系。这种关联的机制尚不清楚。已经表明，下丘脑-垂体-肾上腺（HPA）系统的激活有助于代谢综合征和增强心血管风险。我们研究了皮质醇水平作为 HPA 系统在 RLS 夜间活动的指标，此时 RLS 症状达到最高水平。我们评估了 73 例 RLS 患者和 34 例健康对照者的夜间尿皮质醇排泄情况，同时控制了年龄和性别。尿液采样与多导睡眠记录同时进行。我们发现 RLS 患者夜间皮质醇排泄明显增强，表明 RLS 夜间 HPA 系统过度活跃。HPA 系统过度活跃可能是导致 RLS 患者心血管疾病负担增加的机制之一。夜间皮质醇释放与睡眠障碍的一些多导睡眠图参数呈弱相关，这使得 RLS 引起的睡眠中断对 HPA 系统激活的潜在贡献成为可能。
