Bosphorus Med J. 2022; 9(1): 16-22 | DOI: 10.14744/bmj.2022.96967

Clinical Usefulness of Systemic Inflammatory Markers as Diagnostic and Prognostic Indicators for Restless Leg Syndrome

Buse Çaðla Arý¹, Esma Kobak Tur^2
1Department of Neurology, Bahçeþehir University Faculty of Medicine, Pendik VM Medical Park Hospital, Ýstanbul, Turkey
²Department of Neurology, Fatih Sultan Mehmet Training and Research Hospital, Ýstanbul, Turkey

INTRODUCTION: Iron depletion and dopamine dysfunction are the best-recognized mechanisms in the pathophysiology of restless leg syndrome (RLS). A novel perspective has risen that inflammation plays a part; however, the evidences remain limited. We investigated the potential roles of systemic inflammatory markers in the disease.
METHODS: This cross-sectional study contains 70 patients and 50 healthy controls. We recorded the demographic data from patients’ filed archives. RLS was diagnosed by the International Classification of Sleep Disorders Diagnostic Criteria, The severity of disease was evaluated by the International RLS Study Group Rating Scale and patients were divided into four subgroups as “mild (1–10),” “moderate (11–20),” “severe (21–30)” and “very severe (31–40)” We obtained the blood samples from the medial cubital vein regarding an 8-h of fasting. Red cell distribution width (RDW), platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte (NLR), and C-reactive-protein-to-albumin (CAR) ratios were estimated and compared with controls.
RESULTS: We detected no difference in gender and age among the groups. The mean NLR was 3.42±2.2 in patients and 1.44±0.64 in controls (p=0.001), PLR was 200.54±180.67 in patients and 63.39±13.76 in controls (p=0.001), and RDW was 50.06±4.27 in patients and 45.43±4.28 in controls (p=0.001). All of them were are statistically higher in patients. RDW was predictive at 37.4 with a 85.7% sensitivity and 40.0% specificity. NLR was at 2.33 with a 58.57% sensitivity and 96%, PLR was predictive at 95.34 with a 65.71% sensitivity and 98% specificity.
DISCUSSION AND CONCLUSION: PLR, NLR, and RDW are statistically higher in patients, which supports the hypothesis that there is a relationship between peripheral inflammation and RLS. Moreover, PLR, NLR, and RDW may be used as biomarkers to predict the disease. Additional investigations are needed to understand the nature of the disease.

Keywords: C-reactive protein-to-albumin, neuroinflammation, neutrophil-to-lymphocyte, platelet-to-lymphocyte, red cell distribution width, restless leg syndrome.

---

Sistemik Ýnflamatuar Belirteçlerin Huzursuz Bacak Sendromu Ýçin Tanýsal ve Prognostik Göstergeler Olarak Kullanýrlýlýðý

Buse Çaðla Arý¹, Esma Kobak Tur^2
1Nöroloji Anabilim Dalý, Bahçeþehir Üniversitesi Týp Fakültesi, Pendik VM Medical Park Hastanesi, Ýstanbul, Türkiye
²Fatih Sultan Mehmet Eðitim ve Araþtýrma Hastanesi Nöroloji Anabilim Dalý, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Huzursuz Bacak Sendromu (HBS) patofizyolojisinde demir eksikliði ve dopamin disfonksiyonu en iyi bilinen mekanizmalardýr. Enflamasyonun rol oynadýðýna dair yeni bir bakýþ açýsý ortaya çýkmasýna raðmen kanýtlar sýnýrlýdýr. Bu çalýþmada, sistemik inflamatuar belirteçlerin hastalýktaki potansiyel rollerini araþtýrmayý hedefledik.
YÖNTEM ve GEREÇLER: Bu kesitsel çalýþma 70 hasta ve 50 saðlýklý kontrol içermektedir. Hastalarýn demografik verileri dosyalanmýþ arþivlerinden kaydedildi. HBS, Uluslararasý Uyku Bozukluklarý Taný Kriterleri Sýnýflandýrmasý (ICSD-3) ile teþhis edildi ve þiddeti Uluslararasý Huzursuz Bacak Sendromu Çalýþma Grubu Derecelendirme Ölçeði (IRLSSG) ile deðerlendirildi. Hastalar "hafif (1-10)", "orta (11-20)", "þiddetli (21-30)" ve "çok þiddetli (31-40)" olmak üzere dört alt gruba ayrýldý. 8 saatlik açlýðý takiben medial kübital venden kan örnekleri alýndý. Kýrmýzý hücre daðýlým geniþliði (RDW), trombosit-lenfosit (PLR), nötrofil-lenfosit (NLR) ve C-reaktif-protein-albümin (CAR) oranlarý hesaplandý ve kontrol grubu verileri ile karþýlaþtýrýldý.
BULGULAR: Gruplar arasýnda cinsiyet ve yaþ açýsýndan fark tespit edilmedi. Hastalarda ortalama NLR 3.42±2.2 ve kontrollerde 1.44±0.64 (p=0.001), PLR hastalarda 200.54±180.67 ve kontrollerde 63.39±13.76 (p=0.001) ve RDW hastalarda 50.06±4.27 ve kontrol grubunda 45.43±4.28 saptandý (p=0.001). Tüm belirteçler hasta grubunda istatistiksel olarak daha yüksekti. RDW, %85.7 duyarlýlýk ve %40.0 özgüllük ile 37.4'te öngörücüydü. NLR %58.57 duyarlýlýk ve %96 ile 2.33'te, PLR %65.71 duyarlýlýk ve %98 özgüllük ile 95.34'te öngörücüydü.
TARTIÞMA ve SONUÇ: PLR, NLR ve RDW'nin hastalarda istatistiksel olarak daha yüksek olmasý, periferik inflamasyon ile HBS arasýnda bir iliþki olduðu hipotezini desteklemektedir. Ayrýca, PLR, NLR ve RDW, hastalýðý öngörmek için biyobelirteçler olarak kullanýlabilir. Hastalýðýn doðasýný anlamak için ek araþtýrmalara ihtiyaç vardýr.

Anahtar Kelimeler: C-reaktif protein-albümin oraný, nöroinflamasyon, nötrofil-lenfosit oraný, platelet-lenfosit oraný, kýrmýzý hücre daðýlým geniþliði, huzursuz bacak sendromu.

---

CITE