From the Institute of Epidemiology and Social Medicine (A.S., K.B.), University of Münster, Germany; Institute of Behavioural Sciences (A.S.), Semmelweis University, Budapest, Hungary; Institute for Community Medicine (H.V., W.H.), University Medicine Greifswald; German Centre for Cardiovascular Research (H.V.), Partner site Greifswald; German Centre for Neurodegenerative Diseases (DZNE) (W.H.); Paracelsus-Elena Hospital (C.T.), Kassel; and Department of Neurosurgery (C.T.), University Medicine, Göttingen, Germany.
Neurology. 2014 Jun 3;82(22):2026-33. doi: 10.1212/WNL.0000000000000470. Epub 2014 May 7.
Our aim was to evaluate the association between the cumulative effect of comorbidity and the risk of restless legs syndrome (RLS) in 2 population-based German cohort studies.
The Dortmund Health Study (DHS) (n = 1,312; median follow-up time: 2.1 years) and the Study of Health in Pomerania (SHIP) (n = 4,308; median follow-up time: 5.0 years) were used for the analyses. RLS was assessed at baseline and follow-up according to the RLS minimal criteria. A comorbidity index was calculated as a sum of the following conditions: diabetes, hypertension, myocardial infarction, obesity, stroke, cancer, renal disease, anemia, depression, thyroid disease, and migraine. The relationship between comorbidity and incident RLS was analyzed with multivariate logistic regression models.
An increase in the number of comorbid conditions at baseline predicted prevalent RLS (DHS: trend odds ratio [OR] = 1.24, 95% confidence interval [CI] 0.99-1.56; SHIP: trend OR = 1.34, 95% CI 1.18-1.52) and incident RLS (DHS: trend OR = 1.32, 95% CI 1.04-1.68; SHIP: trend OR = 1.59, 95% CI 1.37-1.85) after adjustment for several covariates. The ORs for incident RLS associated with 3 or more comorbid diseases (DHS: OR = 2.51, 95% CI 1.18-5.34; SHIP: OR = 4.30, 95% CI 2.60-7.11) were higher than the ORs for any single disease.
Multimorbidity was a strong risk factor for RLS in these 2 population-based cohort studies. The results support the hypothesis that cumulative disease burden is more important than the presence of a specific single disease in the pathophysiology of RLS.
我们旨在通过两项基于人群的德国队列研究，评估共病的累积效应与不宁腿综合征（RLS）风险之间的关联。
采用多特蒙德健康研究（DHS）（n=1312；中位随访时间：2.1 年）和波罗的海健康研究（SHIP）（n=4308；中位随访时间：5.0 年）进行分析。RLS 根据 RLS 最低标准在基线和随访时进行评估。共病指数计算为以下疾病的总和：糖尿病、高血压、心肌梗死、肥胖、中风、癌症、肾病、贫血、抑郁、甲状腺疾病和偏头痛。采用多元逻辑回归模型分析共病与新发 RLS 之间的关系。
基线时共病数量的增加预测了 RLS 的患病率（DHS：趋势优势比[OR]为 1.24，95%置信区间[CI]为 0.99-1.56；SHIP：趋势 OR 为 1.34，95%CI 为 1.18-1.52）和 RLS 的新发率（DHS：趋势 OR 为 1.32，95%CI 为 1.04-1.68；SHIP：趋势 OR 为 1.59，95%CI 为 1.37-1.85），经调整多项协变量后。与 3 种或更多共病相关的新发 RLS 的 OR（DHS：OR=2.51，95%CI 为 1.18-5.34；SHIP：OR=4.30，95%CI 为 2.60-7.11）高于任何单一疾病的 OR。
在这两项基于人群的队列研究中，共病是 RLS 的一个强烈危险因素。这些结果支持累积疾病负担比 RLS 病理生理学中特定单一疾病更为重要的假说。
