Association between thyroid function and disease severity in restless legs syndrome

Abstract

BackgroundRestless 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.MethodsSerum 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.ResultsCompared with control group, RLS patients had significantly higher serum thyroid-stimulating hormone (TSH) levels (p < 0.001), and higher prevalence of subclinical hypothyroidism [Odds ratio (OR) 8.00; 95% confidence interval (CI) = 3.50–18.30; p < 0.001]. The Subclinical hypothyroidism rate (47.1 vs. 10%, p < 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; p < 0.001) was independently associated with RLS. There was a statistically significant positive correlation between TSH and the Pittsburgh sleep quality index (PSQI) scores (r = 0.728, p < 0.001), and the International Restless Legs Scales (IRLS) points (r = 0.627, p < 0.001). Spearman correlation analysis showed that FT3 was positive correlated with HAMA14 score (r = 0.239, p = 0.015). In addition, compared with the good-sleeper group, poor-sleeper patients had significantly higher serum TSH levels (p < 0.001).ConclusionSerum 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.

Emotional and behavioral features associated with subclinical hypothyroidism in children and adolescents with Down syndrome

“…We found that participants in the SH group did not exhibit significantly higher scores at the SDSC compared to participants in the control group. This finding is inconsistent with some studies that suggest an association between SH and sleep difficulties ( Iodice et al, 2019 ; Kim et al, 2019 ; Song et al, 2019 ; Green et al, 2021 ; Geng et al, 2022 ). Such inconsistency could be explained, at least in part, by differences in the method used to detect the presence of sleep disorders: some studies used self-report questionnaires specifically designed for the research, others used standardized questionnaires, and still others employed objective measures, such as polysomnography.…”

“…Another research, involving 4,945 participants older than 19 years of age, reported significant associations between SH and sleep duration ( Kim et al, 2019 ). Moreover, there are reports of higher frequency of SH among individuals with restless legs syndrome ( Geng et al, 2022 ). On the other hand, contrasting findings have been reported about the existence of relationships between obstructive sleep apnoea and SH ( Resta et al, 2005 ; Ozcan et al, 2014 ; Petrone et al, 2016 ; Zhang et al, 2016 ).…”

Analysis of Thyroid function and Related Factors in Narcolepsy patients

“…Categorical data were expressed in amount (%) 20 . Spearman or Pearson for correlation analysis 20 .…”

“…Exclusion criteria were as follows: 1) medical history of central nervous system demyelinating disease, central nervous system infection, and intracranial tumors; 2) patients with a history of metabolic illness(e.g., autoimmune liver disease, viral hepatitis, diabetes, and hypertension) were excluded; 3) patients with a history of 131 I treatment for hyperthyroidism, neck radiotherapy, thyroidectomy were excluded; 5) Exclusion of participants with comorbid other forms of sleep disorders (e.g.,OSA, RLS); 6) Comorbid psychiatric disorders were excluded 20 .…”

Is Restless Legs Syndrome De Facto Thyroid Disease?

“…In Nada Ahmed’s 2021 study, patients with hypothyroidism were more likely to show features of RLS compared to the general population (14.3% vs. 8.1%), and an autoimmune background of hypothyreosis was also more frequently found in patients with RLS (29.7% vs. 11.0%) [ 17 ]. Geng et al found that patients with RLS were up to eight times more likely to develop thyroid dysfunction (especially hypothyroidism) compared to the control group [ 18 ]. Researchers from Sao Paulo, on the other hand, assessed the prevalence of RLS among patients with hyperthyroidism in the course of Graves’ disease.…”