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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(08): s00451811231
DOI: 10.1055/s-0045-1811231
Original Article

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

Elif Sarica Darol 
1   Sakarya University, Training and Research Hospital, Neurology Clinic, Sakarya, Türkiye.
,
Dilcan Kotan 
2   Sakarya University, Faculty of Medicine, Department of Neurology, Sakarya, Türkiye.
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Abstract

Background

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.

Objective

To explore the correlation between lower extremity subcutaneous adipose tissue thickness (ATT) and RLS, regardless of body mass index (BMI).

Methods

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.

Results

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.

Conclusion

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.

Keywords

Restless Legs Syndrome - Obesity - Subcutaneous Fat

Data Availability Statement

The datasets generated and/or analyzed as part of the current study are available upon request from the corresponding author.


Authors' Contributions

Conceptualization: ESD; Formal analysis: ESD; Investigation: ESD; Methodology: ESD; Project administration: ESD; Validation: DK; Writing – original draft: ESD; Writing – review & editing: DK.


Editor-in-Chief: Hélio A. G. Teive (https://orcid.org/0000-0003-2305-1073).


Associate Editor: Fernando Morgadinho Santos Coelho (https://orcid.org/0000-0002-8482-3754).




Publication History

Received: 25 February 2025

Accepted: 13 June 2025

Article published online:
31 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Elif Sarica Darol, Dilcan Kotan. Restless legs syndrome and its association with lower extremity adipose tissue thickness: a novel perspective. Arq Neuropsiquiatr 2025; 83: s00451811231.
DOI: 10.1055/s-0045-1811231