Strong bones and restless legs New data about bone remodeling in women with RLS

Abstract

Disorders of bone metabolism are a common concern for older women, since there are known associations among bone loss, sex, and age.(1) Women with restless legs syndrome (RLS) who have not yet been treated with medication have signs of increased sympathetic nervous system activity.(2) The autonomic nervous system appears to be a major regulator of bone mineral density (BMD) through signals sent to osteoblasts, and increased sympathetic activity is associated with more osteoporosis in older women because of decreased osteoblast proliferation.(3) These observations created a plausible hypothesis that there would be a higher incidence of osteopenia or osteoporosis in drug-naive women with RLS. In a new study reported in this issue of Neurology (R), Cikrikcioglu et al.(4) examined this relationship and found no evidence to support this hypothesis. In fact, they discovered the opposite result in their case-control study: an increase in lumbar BMD in 78 women with RLS, compared to 78 age-matched and body mass index (BMI)-matched controls. There was a positive bivariate correlation between duration of RLS and lumbar BMD. They also studied 2 markers of bone resorption, c-telopeptide of type 1 collagen (CTX) and sclerosin, and found lower levels in women with RLS. There were negative bivariate correlations between the severity of RLS and bone resorption markers.