Prospective Study of Restless Leg Syndrome

描述（由首席研究员提供）：不宁腿综合症（RLS）是一种常见的运动障碍，其特征是几乎无法抗拒地移动腿部的冲动。根据最近的估计，它影响着 5-20% 的成年人，并且常常对睡眠、日常活动和生活质量产生重大影响。然而，RLS 的病因仍不清楚。对生活方式因素进行有效评估的大型、特征明确的队列研究可以提供关键信息并带来新的预防和治疗方法。特别是，鉴于 RLS 的患病率很高，需要对 RLS 的临床影响进行进一步的大型前瞻性研究。由于大多数 RLS 患者（约 90%）仍未确诊，基于临床系列的研究可能无法充分代表该疾病的谱系和自然史。一些研究（主要是横断面研究）发现，不宁腿综合征患者的多种慢性疾病（例如心血管疾病和帕金森病）患病率较高，死亡风险也较高。我们在此建议记录两个大型且完善的队列（健康专业人员随访研究 (HPFS) 和护士健康研究 II (NHS II)）中女性和男性参与者中不宁腿综合症的发生情况，目的是解决与不宁腿综合症的病因学和临床影响相关的几个重要假设。 HPFS和NHS II分别于1986年和1989年启动，包括51,529名男性卫生专业人员（1986年45-70岁）和116,678名中年女性注册护士（1989年25-42岁）。 HPFS 自 2002 年起使用标准化问题收集 RLS 信息，NHS II 自 2005 年起收集 RLS 信息。我们将在4-6年的随访中调查1）献血、肥胖、遗传成分是否与RLS风险相关； 2) 在 HPFS (2002-2010) 和 NHS II (2005-2011) 中，RLS 是否与慢性疾病（冠心病、中风、高血压、帕金森病和勃起功能障碍）和死亡率增加有关。我们期望能够记录 5167 个普遍的 RLS 案例和 935 个突发的 RLS 案例，这将为检验所提出的假设提供前所未有的动力。此外，我们队列中 RLS 发生情况的记录是大量信息的重要组成部分，其中包括对 16 年来男性和女性生活方式的多个方面（包括饮食和健康习惯）进行的多重且经过验证的评估，以及前瞻性收集的血液和 DNA 样本。该信息库是独一无二的，对于未来 RLS 以及生物标志物和遗传特征的研究具有重要意义。 公共健康相关性：本申请的主要目的是检查献血、肥胖和遗传成分是否会影响不宁腿综合征的风险，以及不宁腿综合征是否会增加慢性病和死亡率的风险。

DESCRIPTION (provided by principal investigator): The restless legs syndrome (RLS) is a common movement disorder, characterized by an almost irresistible urge to move the legs. According to recent estimates, it affects 5-20 percent of adults and often has a substantial impact on sleep, daily activities and quality of life. However, the etiology of RLS remains unknown. Large, well-characterized cohort studies with validated assessment of lifestyle factors could provide critical information and lead to new approaches for prevention and treatment. Particularly, there is a need of further large prospective studies on the clinical impact of RLS given a high prevalence of the syndrome. Because the majority of RLS patients (~90 percent) remain undiagnosed, studies based on clinical series may not adequately represent the spectrum and natural history of the disease. Some studies, primarily cross-sectional, found that RLS patients had a higher prevalence of a number of chronic diseases (e.g., cardiovascular disease and Parkinson's disease), and an increased risk of mortality. We propose here to document the occurrence of RLS among female and male participants of two large and well established cohorts, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study II (NHS II), for the purpose of addressing several important hypotheses related to the etiology and clinical impacts of RLS. The HPFS and NHS II were initiated in 1986 and 1989 respectively, including 51,529 male health professionals (aged 45-70 in 1986) and 116,678 middle-aged female registered nurses (aged 25-42 in 1989). Information of RLS, using standardized questions, has been collected since 2002 in the HPFS and 2005 in the NHS II. We will investigate 1) whether blood donation, obesity, genetic components are associated with RLS risk during 4-6 years of follow-up; and 2) whether RLS is associated with an increased risk of chronic diseases (coronary heart disease, stroke, hypertension, Parkinson's disease and erectile dysfunction) and mortality in the HPFS (2002-2010) and the NHS II (2005-2011). We expect to be able to document 5167 prevalent and 935 incident RLS cases, which will provide unprecedented power to test the proposed hypotheses. In addition, documentation of the occurrence of RLS in our cohorts is the critical component of a large bank of information that includes multiple and validated assessments of several aspects of lifestyle, including diet and health habits, over a period of 16 years in men and women, and prospectively collected blood and DNA samples. This bank of information is unique and will be of significance for future investigations on RLS and biomarkers and genetic characteristics. PUBLIC HEALTH RELEVANCE: The primary aim of this application is to examine whether blood donation, obesity and genetic components influence risk of restless legs syndrome and whether restless legs syndrome increases risk of chronic diseases and mortality.