Prospective Study of Restless Leg Syndrome

描述（由首席研究员提供）：不宁腿综合征（RLS）是一种常见的运动障碍，其特征是几乎无法抗拒的移动腿部的冲动。根据最近的估计，它影响了5- 20%的成年人，并且经常对睡眠、日常活动和生活质量产生重大影响。然而，RLS的病因尚不清楚。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，并为预防和治疗提供新的方法。特别是，考虑到RLS的高患病率，需要进一步对RLS的临床影响进行大规模的前瞻性研究。由于大多数RLS患者（约90%）仍未得到诊断，基于临床系列的研究可能不能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，RLS患者患多种慢性疾病（如心血管疾病和帕金森病）的患病率较高，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，卫生专业人员随访研究（HPFS）和护士健康研究II （NHS II）中女性和男性参与者的RLS发生情况，目的是解决与RLS病因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年年龄为45-70岁）和116,678名中年女性注册护士（1989年年龄为25-42岁）。自2002年在HPFS和2005年在NHS II中使用标准化问题收集了RLS的信息。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）和死亡率增加的风险相关。我们希望能够记录5167例流行和935例意外的RLS病例，这将为验证所提出的假设提供前所未有的力量。此外，在我们的队列中，RLS发生的记录是一个大型信息库的关键组成部分，该信息库包括对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）的多重和有效评估，以及前瞻性收集的血液和DNA样本。这一信息库是独一无二的，对今后研究RLS、生物标志物和遗传特征具有重要意义。

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.