Szentkirályi A, Völzke H, Hoffmann W, Dörr M, Hense H W, Berger K
Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Germany.
Institute for Community Medicine, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Germany.
Sleep Med. 2017 Jul;35:74-79. doi: 10.1016/j.sleep.2017.04.010. Epub 2017 May 8.
Our aim was to investigate the relationship between impaired peripheral arterial circulation as measured by ankle-brachial index (ABI) and restless legs syndrome (RLS) in the general population.
Data are derived from three independent, German population-based, prospective studies: the control sample of BiDirect (N = 966), the second follow-up of SHIP (N = 2333), and a subsample of SHIP-Trend (N = 1269). RLS was assessed with questions based on the RLS minimal criteria. ABI was measured with an automated method in BiDirect and with Doppler ultrasound in both SHIP studies. An ABI score below 0.9 was indicative of peripheral arterial disease (PAD). Co-morbidities, medications and behavioural factors were self-reported. Additional measurements included body mass index and haemoglobin from blood serum. For BiDirect, a follow-up with identical methodology was performed after a median of 2.5 years.
In cross-sectional analyses, decreased ABI was not significantly associated with RLS as outcome in multivariable logistic regression models adjusted for several potential confounders (BiDirect: odds ratio (OR) = 1.07 for a -0.1 change in ABI, 95% confidence interval (CI): 0.81-1.42, p = 0.62; SHIP-2: OR = 0.99, CI: 0.85-1.16, p = 0.94; SHIP-Trend: OR = 0.99, CI: 0.87-1.13, p = 0.88). Similar non-significant results were achieved using PAD (instead of ABI) as an independent variable. In BiDirect, baseline ABI was not a significant predictor of incident RLS in longitudinal analysis (OR = 0.77, CI: 0.53-1.12, p = 0.17).
Results from three independent studies suggest that reduced ABI is not a risk factor for RLS in the general population.
我们的目的是研究在普通人群中，通过踝臂指数（ABI）测量的外周动脉循环受损与不宁腿综合征（RLS）之间的关系。
数据来自三项独立的、基于德国人群的前瞻性研究：BiDirect的对照样本（N = 966）、SHIP的第二次随访（N = 2333）以及SHIP-Trend的一个子样本（N = 1269）。根据RLS最低标准的问题对RLS进行评估。在BiDirect中使用自动化方法测量ABI，在两项SHIP研究中使用多普勒超声测量。ABI得分低于0.9表明存在外周动脉疾病（PAD）。共病、药物治疗和行为因素通过自我报告获得。其他测量包括体重指数和血清血红蛋白。对于BiDirect，在中位数为2.5年之后采用相同方法进行了随访。
在横断面分析中，在针对多个潜在混杂因素进行调整的多变量逻辑回归模型中，ABI降低与作为结果的RLS无显著关联（BiDirect：ABI每变化-0.1，比值比（OR）= 1.07，95%置信区间（CI）：0.81 - 1.42，p = 0.62；SHIP-2：OR = 0.99，CI：0.85 - 1.16，p = 0.94；SHIP-Trend：OR = 0.99，CI：0.87 - 1.13，p = 0.88）。使用PAD（而非ABI）作为自变量也得到了类似的非显著结果。在BiDirect中，基线ABI在纵向分析中不是新发RLS的显著预测因素（OR = 0.77，CI：0.53 - 1.12，p = 0.17）。
三项独立研究的结果表明，在普通人群中，ABI降低不是RLS的危险因素。
