Mustafa CEYLAN, Recep AYGÜL, Ahmet YALÇIN

Erzurum İli Huzursuz Bacak Sendromu Prevelansının Araştırılması ve Sosyodemografik Özelliklerin İncelenmesi

Giriş: HBS epidemiyoloji çalışmalarında %0.9-10 gibi farklı prevelans oranları bildirilmiştir. HBS hastalarında cinsiyet, yaş, genetik yatkınlık, anemi, hipertansiyon, diyabet, hiperkolesterolemi, depresif bozukluk, tiroid, akciğer ve böbrek hastalıkları gibi eşlik eden komorbid durumlarla ilişkisi araştırılmış ve bazı yerleşkelerde bu özellikler için farklı sonuçlar bildirilmiştir. Çalışmamızda, Erzurum ili HBS prevelansını, sosyodemografik özelliklerini ve komorbid durumlar ile ilişkisini incelemeyi amaçladık. Gereç-Yöntem: Bu çalışma, Atatürk Üniversitesi Tıp Fakültesi Nöroepidemiyoloji Çalışma Grubu tarafından Sağlık müdürlüğüne bağlı olan aile hekimlerinin nüfus kayıtları kullanılarak, kapı kapı gezilerek yapıldı. Her bireyin sosyodemografik özelliklerini ve HBS’ yi belirlemek için iki farklı anket uygulandı. HBS tespit edilen hastalara IRLSSGRS anketi uygulandı. Hastalığın prevalans oranı, yaşa, cinsiyete göre dağılımı ve ilişkili durumlar araştırıldı. İstatistiksel değerlendirmede p≤0.05’ ten küçük olan durumlar anlamlı kabul edildi. Bulgular: 4093 birey değerlendirildi ve 282 (%6.9) HBS’ li olgu tespit edildi. Olguların yaş cinsiyet, sosyodemografik özellikleri ve komorbid durumlar ile ilişkisi araştırıldı (Tablo I). HBS ile komorbid durumların arasında ilişki incelendiğinde tiroid hastalığı haricinde diğer durumlarla HBS arasında anlamlı istatistiksel fark tespit edildi (Tablo I). Vakaların %34.4’ ünde en az bir akrabasında benzer şikâyetleri olduğu tespit edildi. Başlangıç yaşı ≤40 olan olguların oranı daha fazlaydı ve istatistiksel olarak anlamlı fark tespit edildi. HBS semptomlarının orta ve ciddi olduğu gruplarda olgu sayısı fazlaydı (Tablo II). Sonuç: Çalışmamızda 15–80 yaş arası popülâsyonda HBS görülme sıklığını %6.9 tespit ettik. Vakaların yaş gruplarına göre dağılımlarında ise anlamlı farklılık yoktu. HBS ile cinsiyet arasında istatistiksel olarak anlamlı farklılık vardı (p=0.048). Eğitim, ekonomik durum ve meslek ile hastalık arasında ilişki yoktu. HBS’ in sigara ve alkol kullanımı ile ilişkisi yoktu ve komorbid durumlardan tiroid hastalığı haricinde sorgulanan diğer hastalıklarla HBS arasında anlamlı istatistiksel farklılık tespit ettik. Vakaların üçte birinde üst ekstremite tutulumu ve aile öyküsü pozitif olduğu görüldü. Vakaların yarısından fazlasında semptomlar 40 yaşından önce başlamıştı.Tespitlerimiz HBS’ nin sık görüldüğünü, yüksek rakımla sıklığının artabileceğini göstermesi açısından önemlidir.

Anahtar Kelimeler:

Huzursuz Bacak Sendromu, Prevalans, Demografik Faktörler

Investigation of Restless Leg Syndrome Prevalence and Assosiated Sociodemographic Features in Province of Erzurum

AbstractIntroduction: Prevalence of Restless leg syndrome (RLS) is reported between 0.9%-10% in epidemiologic studies. Associations of sex, age, genetic predisposition, anemia, hypertension, diabetes, hypercholesterolemia, depression disorders, thyroid disorders, lung and kidney diseases with RLS were researched and different results were found in different locations. In this study, we aim to investigate the prevalence, sociodemographic features and association of comorbid situations of RLS in the province of Erzurum. Material and Methods: This study was conducted by face-to-face interviews performed by neuroepidemiology study group of Faculty of Medicine of Ataturk University using the records of family doctors abide by health directorate. Two different questionnaires were asked to each contributor to determine the sociodemographic status and RLS consecutively. IRLSSGRS survey was performed to contributors to whom RLS was detected. Prevalence, stratifications for sex and age along with comorbid situations were investigated. A p value lower than 0.05 was accepted as significant in statistical analyzes. Results: Four thousand and ninety-three individuals were investigated and 282 (6.9%) patients with RLS were detected. Data belong to individuals regarding age, sex, sociodemographic features and comorbid situations were obtained (Table I). Regarding the association of comorbid situations, all investigated comorbid situations other than thyroid disorders were associated with RLS (Table I). At least one relative had similar symptoms in 34.4% of the patients. Cases were significantly more frequent under 40 years of age. Number of cases with mild and severe RLS symptoms were higher (Table II). Discussion: In this study, we found the prevalence of RLS 6.9% in the population aged between 15–80 years. There was no statistically significant difference of distribution by means of age groups. There was statistically significant difference by means of gender distribution (p:0.048). There was no connection between disease and education status, economic status and occupation. RLS was not associated with smoking or alcohol consumption. RLS was associated with all investigated comorbid situations other than thyroid disorders. One third of the cases had upper extremity involvement and positive family history. More than half of the cases, symptoms started before the age of 40. Our findings were important in terms of high prevalence and increased disease frequency with high altitude.

Keywords:

Restless Legs Syndrome, Prevalence, Demographic Factors,

PDF

___

1- Ekbom K, Ulfberg J. Restless legs syndrome. J Intern Med. 2009 Nov;266(5):419-31.
2- Sander HH, Eckeli AL, Costa Passos AD, Azevedo L, Fernandes do Prado LB, França Fernandes RM. Prevalence and quality of life and sleep in children and adolescents with restless legs syndrome/Willis-Ekbom disease. Sleep Med. 2017 Feb;30:204-209.
3- Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4:101–19.
4- Michaud M, Dumont M, Selmaoui B, Paquet J, Fantini ML, Montplaisir J. Circadian rhythm of restless legs syndrome: relationship with biological markers. Ann Neurol. 2004 Mar;55(3):372-80.
5- Sudhansu Chokroverty. Restless Legs syndrome. Sleep Disorders. Neurology In Clinical Practice The Neuroloical Disorders. Third Edition. Chapter. 72;1799-1801.
6- Sevim S, Dogu O, Camdeviren H, et al. Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology. 2003;61:1562-9.
7- The International Restless Legs syndrome Study Group. Validation of the International Restless Legs syndrome Study Group rating scale for restless legs syndrome. Sleep Medicine. 4:2003:121-132.
8- Cho SJ, Hong JP, Hahm BJ, et al. Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep. 2009 Aug;32(8):1069-76.
9- Güler S, Caylan A, Nesrin Turan F, Dağdeviren N, Çelik Y. The prevalence of restless legs syndrome in Edirne and its districts concomitant comorbid conditions and secondary complications. Neurol Sci. 2015 Oct;36(10):1805-12.
10- Ulfberg J, Nystrom B, Carter N, Edling C. Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic disease and neuropsychiatric symptoms. Mov Disord 2001; 16:1159–63.
11- Ulfberg J, Nystrom B, Carter N, Edling C. Restless legs syndrome among working-aged women. Eur Neurol 2001;46:17–19.
12- Richard P. Allen, Arthur S. Walters, J. Montplaisir. Restless Legs syndrome Prevalans and Impact. REST General Population Study. Archives of Internal Medicine. 2005;vol.165:1286-1292.
13- Cho YW, Shin WC, Yun CH, et al. Epidemiology of restless legs syndrome in Korean adults. Sleep. 2008;31:219-23.
14- Hadjigeorgiou GM, Stefanidis I, Dardiotis E, et al. Low RLS prevalence and awareness in central Greece: an epidemiological survey. Eur J Neurol. 2007;14:1275-80.
15- Winkelmann J, Wetter TC, Collado-Seidel V, et al. Clinical characteristics and frequency of the hereditary restless legs syndrome in a population of 300 patients. Sleep. 2000;23:597-602.
16- Schlesinger I, Erikh I, Avizohar O, Sprecher E, Yarnitsky D. Cardiovascular Risk Factors in Restless Legs Syndrome. Movement Disorders. 2009:1587-1592.
17- Winkelman JW, Chertow GM, Lazarus JM. Restless legs syndrome in end-stage renal disease. Am J Kidney Dis. 1996:28:372-378.
18- Banno K, Delaive K, Walld R, Kryger MH. Restless legs syndrome in 218 patients: associated disorders. Sleep Med. 2000;1:221-9.
19- Benediktsdottir B, Janson C, Lindberg E, et al. Prevalence of restless legs syndrome among adults in Iceland and Sweden: lung function, comorbidity, ferritin, biomarkers and quality of life. Sleep Med. 2010;11:1043-8.
20- Högl B, Kiechl S, Willeit J, et al. Restless legs syndrome: a community-based study of prevalence, severity, and risk factors. Neurology. 2005;64:1920-4.
21- Vogl FD, Pichler I, Adel S, et al. Restless legs syndrome: epidemiological and clinicogenetic study in a South Tyrolean population isolate. Mov Disord. 2006;21:1189-95.
22- Unruh ML, Levey AS, D'Ambrosio C, Fink NE, Powe NR, Meyer KB. Restless legs symp-toms among incident dialysis patients: association with lower quality of life and shorter survival. Am J Kidney Dis 2004;43:900-909.
23- Gupta R, Ulfberg J, Allen RP, Goel D. High prevalence of restless legs syndrome/Willis Ekbom Disease (RLS/WED) among people living at high altitude in the Indian Himalaya. Sleep Med. 2017 Jul;35:7-11.
24- Nomura T, Inoue Y, Kusumi M, Uemura Y, Nakashima K. Prevalence of restless legs syndrome in a rural community in Japan. Mov Disord. 2008;23:2363-9.
25- Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of RLS: A synthesis of the literature. Sleep medicine Reviews. 2011:1-13.
26- Tasdemir M, Erdo gan H, Börü UT, Dilaver E, Kumas¸ A. Epidemiology of restless legs syndrome in Turkish adults on the western Black Sea coast of Turkey: a door-to-door study in a rural area. Sleep Med. 2010;11:82-6.
27- Lee HB, Hening WA, Allen RP, et al. Restless legs syndrome is associated with DSM-IV major depressive disorder and panic disorder in the community. J Neuropsychiatry Clin Neurosci. 2008;20:101-5.
28- Kim KW, Yoon IY, Chung S, et al. Prevalence, comorbidities and risk factors of restless legs syndrome in the Korean elderly population e results from the Korean Longitudinal Study on Health and Aging. J Sleep Res. 2010;19:87-92.
29- Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res. 2002;53:547-54.
30- Ondo WG, He Y, Rajasekaran S, Le WD. Clinical correlates of 6-hydroxydopamine injections into A11 dopaminergic neurons in rats: a possible model for restless legs syndrome. Mov Disord. 2000;15:154-8.
31- Tings T, Schettler V, Canelo M, Paulus W, Trenkwalder C. Impact of regular LDL apheresis on the development of restless legs syndrome. Mov Disord. 2004;19:1072-1075.
32- Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K. Prevalence and risk factors of RLSin an elderly population: the MEMO study. Memory and morbidity in Augsburg elderly. Neurology. 2000;54:1064-68.
33- Tison F, Crochard A, Léger D, Bouée S, Lainey E, El Hasnaoui A. Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology. 2005;65:239-46.
34- Phillips B, Hening W, Britz P, Mannino D. Prevalence and correlates of restless legs syndrome: results from the 2005 National Sleep Foundation Poll.Chest. 2006;129:76-80.
35- Ondo W, Jankovic C. Restless Legs Syndrome: clinicoetiolologic correlates. Neurology. 1996;47:1435-41.
36- Montplaisir J. Boucher S, Poirier G. Clinical, polysomnografic and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new Standard criteria. Mov Disord. 1997;12:61-65.
37- Winkelmann J, Wetter TC, Collado-Seidel V, et al. Clinical characteristics and frequency of the hereditary restless legs syndrome in a population of 300 patients. Sleep. 2000;23:597-602.
38- Park YM, Lee HJ, Kang SG, et al. Prevalence of idiopathic and secondary restless legs syndrome in Korean women. Gen Hosp Psychiatry. 2010;32:164-8.