Abstract：
Augmentation of restless legs syndrome (RLS) is an iatrogenic side effect induced by dopaminergic agents, and it is a major cause of therapeutic failure. Iron deficiency is a risk factor for RLS, but its effects on the development of RLS augmentation are unclear. This meta-analysis aimed to elucidate the association between serum ferritin and RLS augmentation.
We searched the PubMed, Cochrane Library, Embase, ClinicalKey, ScienceDirect, and ProQuest databases for studies comparing the serum ferritin levels of patients with augmented RLS and nonaugmented RLS. A meta-analysis based on a random-effects model was conducted. Levodopa equivalent dose (LED), International Restless Legs Study Group Severity Rating Scale (IRLS), and serum hemoglobin levels were also analyzed.
Six observational studies fulfilled the eligibility criteria of this meta-analysis. A total of 220 RLS patients with augmentation and 687 RLS patients without augmentation were included. The results revealed that augmented RLS was significantly associated with low serum ferritin levels (p = 0.002), high LEDs (p = 0.026), and nonsignificantly associated with high IRLS scores (p = 0.227).
A low serum ferritin level is associated with RLS augmentation. For patients with RLS who are iron deficient, iron supplements can not only relieve their fundamental RLS symptoms but also lower the risk of RLS augmentation. Moreover, non-dopminergic agents should be considered as the first-line treatment for patients with persistent low serum ferritin levels or those with moderate to severe RLS to prevent augmentation.
We searched the PubMed, Cochrane Library, Embase, ClinicalKey, ScienceDirect, and ProQuest databases for studies comparing the serum ferritin levels of patients with augmented RLS and nonaugmented RLS. A meta-analysis based on a random-effects model was conducted. Levodopa equivalent dose (LED), International Restless Legs Study Group Severity Rating Scale (IRLS), and serum hemoglobin levels were also analyzed.
Six observational studies fulfilled the eligibility criteria of this meta-analysis. A total of 220 RLS patients with augmentation and 687 RLS patients without augmentation were included. The results revealed that augmented RLS was significantly associated with low serum ferritin levels (p = 0.002), high LEDs (p = 0.026), and nonsignificantly associated with high IRLS scores (p = 0.227).
A low serum ferritin level is associated with RLS augmentation. For patients with RLS who are iron deficient, iron supplements can not only relieve their fundamental RLS symptoms but also lower the risk of RLS augmentation. Moreover, non-dopminergic agents should be considered as the first-line treatment for patients with persistent low serum ferritin levels or those with moderate to severe RLS to prevent augmentation.
摘要：
背景：不安腿综合征（RLS）的增加是由多巴胺能药物引起的医源性副作用，这是治疗失败的主要原因。缺铁是RLS的危险因素，但其对RLS增强发展的影响尚不清楚。这项荟萃分析旨在阐明血清铁蛋白与RLS增强之间的关联。
方法：我们搜索了PubMed，科克伦图书馆,Embase,ClinicalKey,ScienceDirect,和ProQuest数据库，用于比较增强RLS和非增强RLS患者的血清铁蛋白水平。进行了基于随机效应模型的荟萃分析。左旋多巴等效剂量（LED），国际不安腿研究组严重程度评定量表（IRLS），和血清血红蛋白水平也进行了分析。
结果：六项观察性研究符合本荟萃分析的资格标准。总共包括220例增强的RLS患者和687例未增强的RLS患者。结果表明，增强的RLS与低血清铁蛋白水平显着相关（p=0.002），高LED（p=0.026），与高IRLS评分无显著相关性(p=0.227)。
结论：低血清铁蛋白水平与RLS增强相关。对于缺铁的RLS患者，铁补充剂不仅可以缓解他们的基本RLS症状，还可以降低RLS增加的风险。此外，对于血清铁蛋白水平持续低的患者或中度至重度RLS患者,应考虑使用非多巴胺能药物作为一线治疗,以防止RLS增加.
方法：我们搜索了PubMed，科克伦图书馆,Embase,ClinicalKey,ScienceDirect,和ProQuest数据库，用于比较增强RLS和非增强RLS患者的血清铁蛋白水平。进行了基于随机效应模型的荟萃分析。左旋多巴等效剂量（LED），国际不安腿研究组严重程度评定量表（IRLS），和血清血红蛋白水平也进行了分析。
结果：六项观察性研究符合本荟萃分析的资格标准。总共包括220例增强的RLS患者和687例未增强的RLS患者。结果表明，增强的RLS与低血清铁蛋白水平显着相关（p=0.002），高LED（p=0.026），与高IRLS评分无显著相关性(p=0.227)。
结论：低血清铁蛋白水平与RLS增强相关。对于缺铁的RLS患者，铁补充剂不仅可以缓解他们的基本RLS症状，还可以降低RLS增加的风险。此外，对于血清铁蛋白水平持续低的患者或中度至重度RLS患者,应考虑使用非多巴胺能药物作为一线治疗,以防止RLS增加.
