An Tianyang, Yuan Lu, Wu Xiuling, Ma Yiming, Sun Haiyang, Lu Baoquan
College of Clinical Medicine, North China University of Science and Technology, Bohai Avenue 21, Tangshan, 063210, Hebei, PR China.
School of Psychology and Mental Health, North China University of Science and Technology, Bohai Avenue 21, Tangshan, 063210, Hebei, PR China.
Sci Rep. 2025 Apr 28;15(1):14867. doi: 10.1038/s41598-025-98055-3.
Restless legs syndrome (RLS) and acute ischemic stroke are prevalent conditions in neurology. Several studies have indicated a relationship between RLS, acute ischemic stroke, and vitamin D levels. This study aimed to evaluate vitamin D levels in patients with RLS after acute ischemic stroke, compared to those with only acute ischemic stroke, to determine if there is a significant association. A case-control study included 270 patients with acute ischemic stroke and 53 patients who developed RLS following acute ischemic stroke. The International Restless Legs Syndrome Study Group (IRLSSG) scale was used to assess RLS severity, and vitamin D levels were measured (levels below 20 ng/ml were considered insufficient). Patients with RLS after acute ischemic stroke had significantly lower vitamin D levels (P < 0.001) and a higher incidence of vitamin D insufficiency (P < 0.001) compared to those with only acute ischemic stroke. The multivariate logistic regression model adjusted for the age, female, smoking status, alcohol consumption, history of hypertension, history of diabetes, low density lipoprotein-cholesterol (LDL-C), Homocysteine (HCY), vitamin D, vitamin D (OR = 0.673, 95% CI: 0.610-0.743, P < 0.001) and sex remained (OR = 4.217, 95% CI: 1.390-12.791, P = 0.011) significantly associated with RLS following acute ischemic stroke. Among RLS patients, those with (extremely) severe RLS had lower vitamin D levels than those with mild to moderate RLS (P < 0.001). Vitamin D levels were negatively correlated with IRLSSG scores after adjusting for confounding factors. The area under the curve (AUC) was 0.915 (95% CI 0.873-0.958), and the cut-off value for vitamin D was 18.15 ng/ml, with a sensitivity of 84.4% and specificity of 90.6%. Adults with acute post-ischemic stroke RLS generally have lower vitamin D levels than those with ischemic stroke alone, and lower vitamin D levels are linked to more severe RLS symptoms. Vitamin D levels and sex are important influencing factors for the occurrence of RLS following acute ischemic stroke. Vitamin D level is an independent predictor of RLS after acute ischemic stroke and has high predictive value.
不宁腿综合征（RLS）和急性缺血性卒中是神经病学中的常见病症。多项研究表明RLS、急性缺血性卒中和维生素D水平之间存在关联。本研究旨在评估急性缺血性卒中后发生RLS的患者与仅患有急性缺血性卒中的患者的维生素D水平，以确定是否存在显著关联。一项病例对照研究纳入了270例急性缺血性卒中患者和53例急性缺血性卒中后发生RLS的患者。采用国际不宁腿综合征研究组（IRLSSG）量表评估RLS严重程度，并测量维生素D水平（低于20 ng/ml被认为不足）。与仅患有急性缺血性卒中的患者相比，急性缺血性卒中后发生RLS的患者维生素D水平显著更低（P < 0.001），维生素D不足的发生率更高（P < 0.001）。多因素逻辑回归模型对年龄、女性、吸烟状况、饮酒、高血压病史、糖尿病病史、低密度脂蛋白胆固醇（LDL-C）、同型半胱氨酸（HCY）、维生素D进行校正后，维生素D（OR = 0.673，95%CI：0.610 - 0.743，P < 0.001）和性别（OR = 4.217，95%CI：1.390 - 12.791，P = 0.011）仍然与急性缺血性卒中后发生的RLS显著相关。在RLS患者中，（极）重度RLS患者的维生素D水平低于轻度至中度RLS患者（P < 0.001）。校正混杂因素后，维生素D水平与IRLSSG评分呈负相关。曲线下面积（AUC）为0.915（95%CI 0.873 - 0.958），维生素D的截断值为18.15 ng/ml，敏感性为84.4%，特异性为90.6%。急性缺血性卒中后发生RLS的成年人维生素D水平通常低于仅患有缺血性卒中的成年人，且较低的维生素D水平与更严重的RLS症状相关。维生素D水平和性别是急性缺血性卒中后发生RLS的重要影响因素。维生素D水平是急性缺血性卒中后RLS的独立预测因素，具有较高的预测价值。
