目的:孤立的REM睡眠行为障碍(IRBD)的特征是REM睡眠的正常失功。IRBD患者存在发生突触核蛋白相关神经退行性疾病(NDD)的重大风险。很少有表型转换的预测因子(从IRBD到NDD)被确定为年龄>65岁,失足,便秘,升高的Epworth嗜睡量表(ESS)。我们旨在检测表型转化的发生率和危险因素。
方法:本研究为回顾性设计。10年后,18例(27.27%)患者出现NDD,48例(72.73%)患者未出现NDD。首次访问的数据(年龄,性别,失足,便秘,ESS,合并症,身体/神经学检查,实验室,和多导睡眠图)在NDD(n:18)和IRBD(46)组之间进行了比较。统计程序IBMSPSSStatisticsVersion20.0用于所有分析。将每个测试的统计学显著性的阈值设定为0.05。
结果:虽然,大多数首次访问数据(年龄,性别,失足,便秘,ESS,实验室,多导睡眠图)在NDD(n:18)和IRBD(n:48)组之间没有差异,糖尿病(DM)频率(p:0.021),DM的平均持续时间(0.027),胸围(p:0.017),NDD的臀围(p:0.045)高于IRBD。如果通过逻辑回归分析计算的表型转换风险仅在DM频率方面不同(p:0.030)[比值比:4.909(1.17-20.19)]。
结论:本研究表明,十年的表型转化率为27.27%,IRBD合并糖尿病患者的表型转化风险增加近五倍。
Isolated REM sleep behavior disorder (IRBD) is characterized by loss of the normal atonia of REM sleep. Patients with IRBD are at substantial risk of developing the synuclein-related neurodegenerative diseases (NDD). Few predictors of
phenoconversion (from IRBD to NDD) have been identified such as age >65 years, hyposmia, constipation, elevated Epworth sleepiness scale (ESS). We aimed to detect rate and risk factors of
phenoconversion.
The study designed as retrospectively. NDD was developed in 18 (27.27%) patients while NDD wasn\'t developed in 48 (72.73%) patients after ten years. The data of the first visit (age, gender, hyposmia, constipation, ESS, comorbidities, physical/neurological examinations, laboratory, and polysomnography) were compared between NDD (n:18) and IRBD (46) groups. The statistical program IBM SPSS Statistics Version 20.0 was used for all analyzes. The threshold for statistical significance for each test was set at 0.05.
Although, most first-visit data (age, gender, hyposmia, constipation, ESS, laboratory, polysomnography) were not different between NDD (n:18) and IRBD (n:48) groups, diabetes mellitus (DM) frequency (p:0.021), mean duration of DM (0.027), chest circumference (p:0.017), and hip circumference (p:0.045) were found higher in NDD than IRBD. If the risk of
phenoconversion calculated by logistic regression analysis was different only in terms of DM frequency (p:0.030) [odds ratio: 4.909 (1.17-20.19)].
The present study showed that the
phenoconversion rate for ten years is 27.27%, and IRBD patients with diabetes mellitus increase the
phenoconversion risk nearly five times.