不宁腿综合征中甲状腺功能与疾病严重程度之间的关联。
Association between thyroid function and disease severity in restless legs syndrome.
作者信息
Geng Chaofan, Yang Zhenzhen, Kong Xiumei, Xu Pengfei, Zhang Hongju
机构信息
Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
Fuwai Central China Cardiovascular Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
出版信息
Front Neurol. 2022 Aug 12;13:974229. doi: 10.3389/fneur.2022.974229. eCollection 2022.
BACKGROUND
Restless Legs Syndrome (RLS) is a common neurological disorder. Growing evidence shows that dopaminergic dysfunction and iron deficiency are associated with the pathogenesis of RLS. Additionally, the dopaminergic system is linked with the hypothalamic-pituitary-thyroid (HPT) axis. Thus, the current study aimed to compare thyroid function between RLS patients and healthy subjects and investigate the associations with clinical characteristics of RLS.
METHODS
Serum levels of thyroid hormones were investigated in 102 first-episode drug-naïve RLS patients and 80 matched healthy controls (HCs). Baseline data and clinical characteristics were performed by professional personnel. In addition, multivariate regression was used to analyze the relationship between thyroid function and RLS.
RESULTS
Compared with control group, RLS patients had significantly higher serum thyroid-stimulating hormone (TSH) levels ( < 0.001), and higher prevalence of subclinical hypothyroidism [Odds ratio (OR) 8.00; 95% confidence interval (CI) = 3.50-18.30; < 0.001]. The Subclinical hypothyroidism rate (47.1 vs. 10%, < 0.001) in RLS patients was higher than the HCs group. Regression analysis revealed that serum TSH (OR = 1.77; 95% CI = 1.41-2.23; < 0.001) was independently associated with RLS. There was a statistically significant positive correlation between TSH and the Pittsburgh sleep quality index (PSQI) scores ( = 0.728, < 0.001), and the International Restless Legs Scales (IRLS) points ( = 0.627, < 0.001). Spearman correlation analysis showed that FT was positive correlated with HAMA score ( = 0.239, = 0.015). In addition, compared with the good-sleeper group, poor-sleeper patients had significantly higher serum TSH levels ( < 0.001).
CONCLUSION
Serum levels of TSH and the prevalence of subclinical hypothyroidism were higher in RLS patients, indicating the imbalance between thyroid hormones (TH) and the dopaminergic system may contribute to the development of primary RLS. Additionally, the TH axis may influence the quality of sleep in RLS patients.
背景
不安腿综合征（RLS）是一种常见的神经系统疾病。越来越多的证据表明，多巴胺能功能障碍和铁缺乏与RLS的发病机制有关。此外，多巴胺能系统与下丘脑 - 垂体 - 甲状腺（HPT）轴相关。因此，本研究旨在比较RLS患者和健康受试者的甲状腺功能，并探讨其与RLS临床特征的关联。
方法
对102例初发未用药的RLS患者和80例匹配的健康对照（HCs）进行血清甲状腺激素水平检测。由专业人员收集基线数据和临床特征。此外，采用多因素回归分析甲状腺功能与RLS之间的关系。
结果
与对照组相比，RLS患者血清促甲状腺激素（TSH）水平显著升高（<0.001），亚临床甲状腺功能减退的患病率更高[比值比（OR）8.00；95%置信区间（CI）=3.50 - 18.30；<0.001]。RLS患者的亚临床甲状腺功能减退率（47.1%对10%，<0.001）高于HCs组。回归分析显示，血清TSH（OR = 1.77；95% CI = 1.41 - 2.23；<0.001）与RLS独立相关。TSH与匹兹堡睡眠质量指数（PSQI）评分（=0.728，<0.001）和国际不安腿量表（IRLS）得分（=0.627，<0.001）之间存在统计学显著正相关。Spearman相关性分析显示，游离甲状腺素（FT）与汉密尔顿焦虑量表（HAMA）评分呈正相关（=0.239，=0.015）。此外，与睡眠良好组相比，睡眠不佳的患者血清TSH水平显著更高（<0.001）。
结论
RLS患者血清TSH水平和亚临床甲状腺功能减退的患病率更高，表明甲状腺激素（TH）与多巴胺能系统之间的失衡可能导致原发性RLS的发生。此外，TH轴可能影响RLS患者的睡眠质量。
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