Neutrophil‑to‑lymphocyte ratio as a marker of inflammation in restless legs syndrome during pregnancy

Abstract

PURPOSE: The pregnancy is accepted as an independent risk factor for restless legs syndrome/Willis-Ekbom disease (RLS/WED). The neutrophil-to-lymphocyte ratio (NLR) was recently reported in the pathophysiology of RLS/WED. In this report, we investigated the relationship between the presence of RLS/ WED and the levels of NLR in pregnancy. METHODS: We included 268 pregnant women attending routine prenatal visits; 148 women had RLS/WED, and 120 women without RLS/WED were the control group. A pre-formed questionnaire was administered to all participants regarding demographic characteristics, habitual behaviors, detailed medical history and questions about RLS/WED including disease duration, severity, and family history. Laboratory investigations were performed in all participants regarding the complete blood count, NLR, fasting blood glucose, blood urea nitrogen, creatinine, ferritin, and total iron binding capacity. RESULTS: NLR was signifi cantly higher in pregnant women with RLS/WED as compared to those without it (3.9±0.9 versus 3.5± 1.1, p = 0.039). Smoking was also signifi cantly more common in pregnant women with RLS/WED (p=0.022). NLR signifi cantly increased as the gestational period progressed, even after the adjustments for age, BMI, and smoking (p = 0.035). Higher NLR in pregnant women with RLS/WED was especially prominent in the 3rd trimester, although the difference was not signifi cant. CONCLUSION: These results may suggest that an increased infl ammation demonstrated by the increased NLR, may, in part, play a role in higher prevalence of RLS/WED in pregnancy, especially in late gestational weeks (Tab. 2, Fig. 1, Ref. 34).

Evaluation of the relationship between idiopathic restless legs syndrome and serum hepcidin levels

“…Although RLS has been a known disease for many long years, the diagnosis is predominantly made clinically, and the absence of a method to confirm the diagnosis causes underdiagnoses or misdiagnoses (Bellei et al., 2018 ). It is seen that some of the studies focused on RLS‐related inflammatory factors such as CRP and neutrophil–lymphocyte ratio, whereas another part focused on iron metabolism factors (Jiménez‐Jiménez et al., 2023 ; Karadeniz et al., 2023 ). The underlying mechanism of reduced iron concentration in the brains of RLS patients is not yet understood.…”