Restless legs syndrome and its association with lower extremity adipose tissue thickness: a novel perspective

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs often linked to risk factors such as female gender and obesity.To explore the correlation between lower extremity subcutaneous adipose tissue thickness (ATT) and RLS, regardless of body mass index (BMI).A total of 212 RLS patients and 92 controls were included in this study. The ATT measurements were obtained using a caliper at the midcalf and knee regions and compared between groups. Data analysis was conducted using the IBM SPSS Statistics For Windows (IBM Corp.) software, version 23.0, with multiple logistic regression modeling employed. Values of p < 0.05 were considered statistically significant.The BMI and ATT were significantly higher in female patients (p < 0.001). Notably, patients experienced substantial weight gain in the second decade of symptom onset. Midcalf ATT was significantly lower in RLS patients than controls (p < 0.0005). The likelihood of RLS increased 1.107 times with each unit decrease in midcalf ATT, 1.051 times per increase in year of age, 1.015 times per unit decrease in ferritin level, and 1.072 times per unit decrease in the vitamin D level.The present study suggests a potential role of leg subcutaneous adipose tissue in RLS pathophysiology, regardless of BMI; it may influence RLS symptoms, offering a novel perspective on its etiology. Further research is warranted to validate these observations and investigate the underlying mechanisms.