Abstract：
BACKGROUND: Recent studies suggest the existence of a physiologic basis for bone rarefaction and increased risk for fractures. This study aimed to address anthropometric differences between patients with narcolepsy type 1 (NT1) and type 2 (NT2) and discrepancies in bone mineral content (BMC) as a function of hypocretin-1 (Hcrt-1) measured in cerebrospinal fluid (CSF).
METHODS: We have evaluated 31 adult patients (aged 18-65 years) with NT1 and 18 patients with NT2, comparing the groups in terms of anthropometric variables - body mass index (BMI) and waist-to-hip ratio (WHR) - and percentage of bone mineral content (%BMC), measured by bioelectrical impedance analysis (BIA). Statistical analysis assessed the effects of Hcrt-1 levels on CSF, dietary intake, and medication use over these variables. Statistical significance was achieved with a confidence interval of 95 % and p < 0.05.
RESULTS: Patients with NT1 presented with higher BMI (32.04 ± 6.95 vs. 25.38 ± 4.26 kg/m2; p < 0.01) and WHR (0.89 ± 0.09 vs. 0.83 ± 0.09; p = 0.02) compared to NT2, in detriment of %BMC, which was lower for NT1 (4.1 ± 1.02 vs. 4.89 ± 0.59; p < 0.01). Hcrt-1 in CSF showed a positive correlation with %BMC (r = +0.48, p < 0.01) and a negative correlation with anthropometric features (BMI: r = -0.54, p < 0.01; WHR: r = -0.37, p = 0.01). There was a correlation between WHR and diary caloric intake (r = +0.42, p < 0.01).
CONCLUSIONS: The evaluation of patients with narcolepsy presupposes a syndromic approach comprising symptoms that go far beyond excessive daytime sleepiness. The integrated follow-up, including nutritional profile and anthropometric features, should add value in reducing morbidity in this population.
METHODS: We have evaluated 31 adult patients (aged 18-65 years) with NT1 and 18 patients with NT2, comparing the groups in terms of anthropometric variables - body mass index (BMI) and waist-to-hip ratio (WHR) - and percentage of bone mineral content (%BMC), measured by bioelectrical impedance analysis (BIA). Statistical analysis assessed the effects of Hcrt-1 levels on CSF, dietary intake, and medication use over these variables. Statistical significance was achieved with a confidence interval of 95 % and p < 0.05.
RESULTS: Patients with NT1 presented with higher BMI (32.04 ± 6.95 vs. 25.38 ± 4.26 kg/m2; p < 0.01) and WHR (0.89 ± 0.09 vs. 0.83 ± 0.09; p = 0.02) compared to NT2, in detriment of %BMC, which was lower for NT1 (4.1 ± 1.02 vs. 4.89 ± 0.59; p < 0.01). Hcrt-1 in CSF showed a positive correlation with %BMC (r = +0.48, p < 0.01) and a negative correlation with anthropometric features (BMI: r = -0.54, p < 0.01; WHR: r = -0.37, p = 0.01). There was a correlation between WHR and diary caloric intake (r = +0.42, p < 0.01).
CONCLUSIONS: The evaluation of patients with narcolepsy presupposes a syndromic approach comprising symptoms that go far beyond excessive daytime sleepiness. The integrated follow-up, including nutritional profile and anthropometric features, should add value in reducing morbidity in this population.
摘要：
背景：最近的研究表明存在骨稀疏和骨折风险增加的生理基础。这项研究旨在解决1型发作性睡病（NT1）和2型发作性睡病（NT2）患者之间的人体测量学差异，以及脑脊髓液（CSF）中测得的Hcrt-1（Hcrt-1）的骨矿物质含量（BMC）差异。
方法：我们评估了31名患有NT1的成年患者（年龄在18-65岁）和18名患有NT2的成年患者，比较了人体测量变量-体重指数（BMI）和腰臀比（WHR）-和骨矿物质含量百分比（％BMC）。通过生物电阻抗分析(BIA)测量。统计分析评估了Hcrt-1水平对CSF的影响，饮食摄入量，和药物使用超过这些变量。以95%的置信区间和p<0.05实现统计学显著性。
结果：NT1患者的BMI更高（32.04±6.95vs.25.38±4.26kg/m2；p<0.01）和WHR（0.89±0.09vs.0.83±0.09；p=0.02）与NT2相比，损害了%BMC，NT1较低（4.1±1.02与4.89±0.59；p<0.01）。CSF中的Hcrt-1与％BMC呈正相关（r=0.48，p<0.01），与人体测量特征呈负相关（BMI：r=-0.54，p<0.01；WHR：r=-0.37，p=0.01）。WHR与日记热量摄入之间存在相关性（r=0.42，p<0.01）。
结论：对发作性睡病患者进行评估的前提是综合征性治疗方法包括远远超出白天过度嗜睡的症状。综合后续行动，包括营养特征和人体测量特征，应该增加降低这一人群发病率的价值。
方法：我们评估了31名患有NT1的成年患者（年龄在18-65岁）和18名患有NT2的成年患者，比较了人体测量变量-体重指数（BMI）和腰臀比（WHR）-和骨矿物质含量百分比（％BMC）。通过生物电阻抗分析(BIA)测量。统计分析评估了Hcrt-1水平对CSF的影响，饮食摄入量，和药物使用超过这些变量。以95%的置信区间和p<0.05实现统计学显著性。
结果：NT1患者的BMI更高（32.04±6.95vs.25.38±4.26kg/m2；p<0.01）和WHR（0.89±0.09vs.0.83±0.09；p=0.02）与NT2相比，损害了%BMC，NT1较低（4.1±1.02与4.89±0.59；p<0.01）。CSF中的Hcrt-1与％BMC呈正相关（r=0.48，p<0.01），与人体测量特征呈负相关（BMI：r=-0.54，p<0.01；WHR：r=-0.37，p=0.01）。WHR与日记热量摄入之间存在相关性（r=0.42，p<0.01）。
结论：对发作性睡病患者进行评估的前提是综合征性治疗方法包括远远超出白天过度嗜睡的症状。综合后续行动，包括营养特征和人体测量特征，应该增加降低这一人群发病率的价值。
