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Author Notes:

Correspondence: 1841 Clifton Rd NE, Atlanta, GA 30329; Email: Lbecke2@emory.edu; Phone: (404) 728-4752; Fax: (404) 728-6575

Disclosures: Drs. Trotti and Rye have been consultants for UCB Pharma, and Dr. Rye has given CME lectures sponsored by UCB Pharma.

Dr. Bliwise is a consultant for Ferring.

The remaining authors declare that they have no conflicts of interest.

Subject:

Research Funding:

Supported by PHS Grant KL2RR025009 from the Clinical and Translational Science Award program (LMT), 2P50AG025688, and P30NS055077.

Keywords:

  • C-reactive protein
  • periodic leg movements of sleep
  • restless legs syndrome
  • interleukin-6
  • tumor necrosis factor alpha
  • cardiovascular disease

Elevated C-reactive protein is associated with severe periodic leg movements of sleep in patients with restless legs syndrome

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Journal Title:

Brain, Behavior, and Immunity

Volume:

Volume 26, Number 8

Publisher:

, Pages 1239-1243

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background Restless legs syndrome (RLS) is a common sleep disorder in which urges to move the legs are felt during rest, are felt at night, and are improved by leg movement. RLS has been implicated in the development of cardiovascular disease. Periodic leg movements (PLMs) may be a mediator of this relationship. We evaluated systemic inflammation and PLMs in RLS patients to further assess cardiovascular risk. Methods 137 RLS patients had PLM measurements taken while unmedicated for RLS. Banked plasma was assayed for high sensitivity C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-alpha). Results Mean (SD) PLM index was 19.3 (22.0). PLMs were unrelated to TNF-a and IL-6, but were modestly correlated with log CRP (r(129) = 0.19, p = 0.03). Those patients with at least 45 PLMs/hour had an odds ratio of 3.56 (95% CI 1.26 to 10.03, p = 0.02, df = 1) for having elevated CRP compared to those with fewer than 45 PLMs/hour. After adjustment for age, race, gender, diabetes, hypertension, hyperlipidemia, inflammatory disorders, CRP-lowering medications, and body mass index, the OR for those with ≥ 45 PLMs/hour was 8.60 (95% CI 1.23 to 60.17, p = 0.03, df = 10). Conclusions PLMs are associated with increased inflammation, such that those RLS patients with at least 45 PLMs/hour had more than triple the odds of elevated CRP than those with fewer PLMs. Further investigation into PLMs and inflammation is warranted.

Copyright information:

© 2012 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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