Cubo Esther, Gallego-Nieto Cesar, Elizari-Roncal Miren, Barroso-Pérez Teresa, Collazo Carla, Calvo Sara, Delgado-López Pedro David
Neurology Department, Hospital Universitario Burgos, ES.
Health Science Department, University of Burgos, ES.
Tremor Other Hyperkinet Mov (N Y). 2019 Jul 19;9. doi: 10.7916/tohm.v0.650. eCollection 2019.
Restless legs syndrome (RLS) is a common sleep disorder,. although controversial, growing evidence relates the presence of RLS to an increased risk of mortality, mainly due to cardiovascular events. The aim of this article was to review the role of RLS as a risk factor of mortality according to independent cohort studies.
We performed a literature review via PubMed database for articles relating RLS and mortality. We used the random-effects model to calculate the pooled effect estimates on mortality. Heterogeneity between studies was assessed using quantitative and qualitative analysis.
Out of 100 articles identified, 13 were finally included. Although studies were heterogeneous ( = 0.001), no significant publication bias was found. When all cohort studies were considered, the random-effects model yielded a significantly increased risk of mortality in RLS versus non-RLS patients (13 studies, hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.28-1.80). However, this association was not statistically significant when only cohort studies using the international RLS diagnostic criteria were considered (5 studies, HR = 1.63, 95% CI 0.94-2.81).
The results of this meta-analysis suggest that RLS seems to be a risk factor of mortality, although this association is conditioned by the diagnostic criteria used in the studies. Future long-term follow-up standardized mortality studies are needed to address this important question that carries potential impact on population global health.
不宁腿综合征（RLS）是一种常见的睡眠障碍。尽管存在争议，但越来越多的证据表明，RLS的存在与死亡率增加有关，主要是由于心血管事件。本文的目的是根据独立队列研究，综述RLS作为死亡风险因素的作用。
我们通过PubMed数据库对有关RLS和死亡率的文章进行了文献综述。我们使用随机效应模型来计算死亡率的合并效应估计值。使用定量和定性分析评估研究之间的异质性。
在检索到的100篇文章中，最终纳入13篇。尽管研究存在异质性（I² = 0.001），但未发现明显的发表偏倚。当考虑所有队列研究时，随机效应模型显示RLS患者的死亡率风险显著高于非RLS患者（13项研究，风险比[HR] = 1.52，95%置信区间[CI] 1.28 - 1.80）。然而，当仅考虑使用国际RLS诊断标准的队列研究时，这种关联无统计学意义（5项研究，HR = 1.63，95% CI 0.94 - 2.81）。
这项荟萃分析的结果表明，RLS似乎是一个死亡风险因素，尽管这种关联受研究所用诊断标准的影响。需要未来进行长期随访的标准化死亡率研究来解决这个对全球人群健康有潜在影响的重要问题。
