title: The Association of Restless Legs Syndrome to History of Gestational Diabetes in an Appalachian Primary Care Population.
abstract: OBJECTIVE
  Restless legs syndrome (RLS) is a burdensome sensorimotor disorder that has been linked to diabetes and obesity. However, the relationship of RLS to gestational diabetes mellitus (GDM), a common pregnancy complication strongly associated with obesity and a harbinger of diabetes, remains unknown. In this study, we examined the association of RLS to history of GDM in a sample of older female primary care patients.
  
  
  METHODS
  Participants were community-dwelling women aged ≥ 40 years drawn from an anonymous survey study of West Virginia adult primary care patients. Data gathered included detailed information on demographics, lifestyle factors, reproductive history, sleep patterns, and medical history; the survey also included an RLS diagnostic questionnaire. Women who were pregnant or had missing data on key variables were excluded from the analyses.
  
  
  RESULTS
  Of the 498 participants included in the final analytic sample, 24.5% met diagnostic criteria for RLS (17.9% with symptoms at least once/week). After adjustment for demographics, lifestyle characteristics, body mass index, diabetes and other comorbid conditions, parity, and other factors, those reporting history of GDM were almost three times as likely to meet criteria for RLS (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.3, 5.3). This association increased in magnitude with increasing symptom frequency (adjusted OR for RLS symptoms ≥ 3×/week = 4.8, CI 2.1, 11.2, p for trend = 0.004).
  
  
  CONCLUSIONS
  History of GDM was strongly and positively related to RLS in this study of older female primary care patients, offering further support for a possible role of metabolic dysregulation in RLS development.
authors.affiliation: Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV.|Center for the Study of Complementary and Alternative Therapies and Department of Physical Medicine and Rehabilitation, University of Virginia Health System, Charlottesville, VA.
authors.forename: Kim E
authors.initials: KE
authors.lastname: Innes
authors.affiliation: Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV.
authors.forename: Sahiti
authors.initials: S
authors.lastname: Kandati
authors.affiliation: Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV.|WV Focus: Reproductive Education & Equality, Charleston, WV.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Flack
authors.affiliation: Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV.
authors.forename: Parul
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV.|Center for the Study of Complementary and Alternative Therapies and Department of Physical Medicine and Rehabilitation, University of Virginia Health System, Charlottesville, VA.
authors.forename: Terry Kit
authors.initials: TK
authors.lastname: Selfe
mesh_terms: D000328:Adult; D000368:Aged; D001061:Appalachian Region / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011247:Pregnancy; D011320:Primary Health Care; D012148:Restless Legs Syndrome / Q000453:epidemiology*; D014903:West Virginia / Q000453:epidemiology
keywords: Willis-Ekbom disease; gestational diabetes; metabolic syndrome; pregnancy complications; restless legs syndrome; sleep