The association between vitamin D and restless legs syndrome following acute ischemic stroke

Abstract

Restless legs syndrome (RLS) and acute ischemic stroke are prevalent conditions in neurology. Several studies have indicated a relationship between RLS, acute ischemic stroke, and vitamin D levels. This study aimed to evaluate vitamin D levels in patients with RLS after acute ischemic stroke, compared to those with only acute ischemic stroke, to determine if there is a significant association. A case-control study included 270 patients with acute ischemic stroke and 53 patients who developed RLS following acute ischemic stroke. The International Restless Legs Syndrome Study Group (IRLSSG) scale was used to assess RLS severity, and vitamin D levels were measured (levels below 20 ng/ml were considered insufficient). Patients with RLS after acute ischemic stroke had significantly lower vitamin D levels (P < 0.001) and a higher incidence of vitamin D insufficiency (P < 0.001) compared to those with only acute ischemic stroke. The multivariate logistic regression model adjusted for the age, female, smoking status, alcohol consumption, history of hypertension, history of diabetes, low density lipoprotein-cholesterol (LDL-C), Homocysteine (HCY), vitamin D, vitamin D (OR = 0.673, 95% CI: 0.610-0.743, P < 0.001) and sex remained (OR = 4.217, 95% CI: 1.390-12.791, P = 0.011) significantly associated with RLS following acute ischemic stroke. Among RLS patients, those with (extremely) severe RLS had lower vitamin D levels than those with mild to moderate RLS (P < 0.001). Vitamin D levels were negatively correlated with IRLSSG scores after adjusting for confounding factors. The area under the curve (AUC) was 0.915 (95% CI 0.873-0.958), and the cut-off value for vitamin D was 18.15 ng/ml, with a sensitivity of 84.4% and specificity of 90.6%. Adults with acute post-ischemic stroke RLS generally have lower vitamin D levels than those with ischemic stroke alone, and lower vitamin D levels are linked to more severe RLS symptoms. Vitamin D levels and sex are important influencing factors for the occurrence of RLS following acute ischemic stroke. Vitamin D level is an independent predictor of RLS after acute ischemic stroke and has high predictive value.

Keywords: 25-hydroxyvitamin D; Acute ischemic stroke; Restless legs syndrome; Vitamin D.

Fig. 1

Patient recruitment profile of the study.

Fig. 2

ROC curve of vitamin D levels for predicting RLS after acute ischemic stroke.