Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Neurology. 2013 Jul 2;81(1):52-9. doi: 10.1212/WNL.0b013e318297eee0. Epub 2013 Jun 12.
To prospectively examine whether men with restless legs syndrome (RLS) had an increased risk of mortality.
This was a prospective cohort study of 18,425 US men free of diabetes, arthritis, and renal failure in the Health Professionals Follow-up Study (HPFS). In 2002, RLS was assessed using a set of standardized questions. Deaths were identified from state vital statistics records, the National Death Index, family reports, and the postal system.
During 8 years of follow-up (2002-2010), we documented 2,765 deaths. In an age-adjusted model, RLS was associated with a 39% increased risk of mortality (hazard ratio [HR] = 1.39; 95% confidence interval [CI] 1.19-1.62; p < 0.0001). The association between RLS and mortality was slightly attenuated after further adjustment for body mass index, lifestyle factors, chronic conditions, sleep duration, and other sleep-related disorders (adjusted HR = 1.30; 95% CI 1.11-1.52; p = 0.003). When we further excluded those with major chronic conditions (e.g., cancer, high blood pressure, cardiovascular disease, and other comorbidities), the adjusted HR was 1.92 (95% CI 1.03-3.56; p = 0.04). The interactions between RLS and other risk factors (older age, overweight, short sleep duration, smoking, low physical activity, and unhealthy diet) in relation to total mortality risk were not significant (p for interaction >0.2 for all).
We observed that men with RLS had a higher overall mortality and this association was independent of known risk factors. The increased mortality in RLS was more frequently associated with respiratory disease, endocrine disease, nutritional/metabolic disease, and immunologic disorders. Future research exploring the pathophysiologic relationship between these disorders and RLS is warranted.
前瞻性研究不安腿综合征（RLS）男性患者的死亡率是否增加。
这是一项对美国健康专业随访研究（HPFS）中 18425 名无糖尿病、关节炎和肾衰竭的男性进行的前瞻性队列研究。2002 年，通过一组标准化问题评估 RLS。通过州生命统计记录、国家死亡索引、家庭报告和邮政系统确定死亡。
在 8 年的随访期间（2002-2010 年），我们记录了 2765 例死亡。在年龄调整模型中，RLS 与死亡率增加 39%相关（风险比 [HR] = 1.39；95%置信区间 [CI] 1.19-1.62；p < 0.0001）。进一步调整体重指数、生活方式因素、慢性疾病、睡眠时间和其他与睡眠相关的疾病后，RLS 与死亡率之间的关联略有减弱（调整后的 HR = 1.30；95%CI 1.11-1.52；p = 0.003）。当我们进一步排除那些患有主要慢性疾病（如癌症、高血压、心血管疾病和其他合并症）的患者时，调整后的 HR 为 1.92（95%CI 1.03-3.56；p = 0.04）。RLS 与其他危险因素（年龄较大、超重、睡眠时间短、吸烟、低体力活动和不健康饮食）之间的相互作用与总死亡率风险无关（p 交互作用>0.2）。
我们观察到 RLS 男性的总体死亡率较高，且这种关联独立于已知的危险因素。RLS 患者的死亡率增加更多地与呼吸疾病、内分泌疾病、营养/代谢疾病和免疫疾病相关。需要进一步研究这些疾病与 RLS 之间的病理生理关系。
