The prevalence and clinical characteristics of restless legs syndrome in patients with iron deficiency anemia in Korea

Implications of Iron Deficiency Anaemia on Glycemic Dynamics in Diabetes Mellitus: A Critical Risk Factor in Cardiovascular Disease

BACKGROUND

Iron deficiency anemia (IDA) is a highly prevalent comorbidity in patients with diabetes, with rates estimated between 13% and 47% across studies. Iron deficiency anemia may potentially influence hemoglobin A1c (HbA1c) values, which are routinely measured to monitor long-term glycemic control in diabetes. Some evidence suggests that HbA1c may be lower in diabetics with IDA due to increased red blood cell turnover. However, current evidence elucidating the effects of IDA on HbA1c and diabetes outcomes remains inconsistent and inconclusive.

OBJECTIVE

This cross-sectional study aimed to evaluate the relationship between IDA, HbA1c levels, and glycemic dynamics in patients with diabetes mellitus.

METHODS

The study sample included 143 adult patients diagnosed with diabetes, recruited from outpatient clinics in Saudi Arabia. Iron deficiency anemia was identified through serum ferritin <100 ng/mL, transferrin saturation <20%, and hematologic parameters. The HbA1c levels were measured using standardized laboratory methods. Daily glucose profiles were obtained by continuous glucose monitoring (CGM) in a subset of patients to assess glycemic dynamics.

RESULTS

The prevalence of IDA was 39.9% among the diabetic cohort. Patients with IDA had a numerically higher mean HbA1c of 7.2% compared to 6.8% in non-anemic diabetics, suggesting a potential effect of IDA on HbA1c. Those with IDA also spent more time in hyperglycemic ranges, along with greater glucose variability based on CGM data. Iron deficiency measures, including low ferritin and high red cell distribution width (RDW), showed weak positive correlations with HbA1c levels.

CONCLUSION

Iron deficiency anemia is highly prevalent among Saudi diabetic patients and is potentially associated with inaccurate HbA1c values and poor short-term glycemic control. However, larger controlled studies are warranted to conclusively investigate mechanisms linking IDA to alterations in HbA1c and glycemic dynamics. Optimized screening and treatment of IDA may lead to more accurate diabetes monitoring and improved outcomes.

The relationship between iron deficiency anemia with restless leg syndrome and sleep quality in workers working in a textile factory in Iran: a cross-sectional study

Background

The aim of this study is to investigate the relationship between iron deficiency anemia with restless leg syndrome (RLS) and sleep quality in workers working in a textile factory in Iran. This cross-sectional study was conducted on 216 workers working in a textile factory in Iran. In addition to demographic and occupational variables, Pittsburgh Sleep Quality Index (PSQI) and RLS questionnaires were used for the data collection. To investigate iron deficiency anemia, 2 CC of blood was taken from the brachial artery with the help of a 10-CC syringe with a blue or pink tip. Then, relevant data were entered into SPSS26 and analyzed.

Results

The mean (S. D.) age of the workers was 32.23 (6.14) and 60.6% of them were women. The prevalence of iron deficiency anemia was 21.2 and 69.5% in men and women, respectively. Most of the workers were in moderate condition in terms of RLS severity, and 78.2% had sleep disorders. There was an inverse and significant correlation between age (β= −0.200), work experience (β= −0.160), hemoglobin (β= −0.149), and ferritin (β= −0.186) with global PSQI score (P value<0.05). Also, an inverse and significant correlation was observed between age (β= −0.164), hemoglobin (β= −0.548), and ferritin (β= −0.410) with RLS score (P value<0.05). However, there was a direct and significant correlation between TIBC level and RLS score (β= 0.227) and global PSQI score (β= 0.395) (P value<0.05).

Conclusions

Intervention programs to reduce iron deficiency anemia and periodic screening programs to identify sleep disorders and RLS in textile factory workers seem necessary.

Olanzapine-induced restless leg syndrome (Willis-Ekbom disease): A case report

Restless leg syndrome, also known as Willis-Ekbom disease, is a neurological sensorimotor disorder accompanied by an irresistible urge to move the legs with a fluctuating course of symptoms. It is a common disorder affecting all ages, with existing comorbidities and positive family history being associated with increased prevalence. Herein, we present a case of a 51-year-old female diagnosed with the bipolar affective disorder who developed restless leg syndrome following the use of olanzapine. Olanzapine is a second-generation antipsychotic which can cause restless leg syndrome due to its anti-dopaminergic action on the nervous system, particularly the spinal cord. Existing literature on olanzapine-induced restless leg syndrome has suggested managing this disorder by reducing the dose or replacing olanzapine with other drugs such as clonazepam, quetiapine, and aripiprazole. In our case, olanzapine was not replaced with other medications as the patient showed a significant improvement in bipolar affective disorder symptoms using olanzapine. Instead, clonazepam was added to the treatment regimen which was scheduled to be taken before olanzapine.

Associations between anemia and insomnia or excessive daytime sleepiness in older adults

OBJECTIVE

Sleep disorders including excessive daytime sleepiness (EDS), insomnia and anemia are both common. The aim of this study is to investigate associations between anemia and insomnia/EDS in the elderly.

METHODS

A total of 744 older outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin concentration below 12 g/dL in females and <13 g/dl in males. Patients were divided into two groups as anemic and non-anemic. The Epworth Sleepiness Scale score of ≥11 points indicates EDS. Insomnia Severity Index with scores of ≥8 indicates insomnia.

RESULTS

The mean age was 79.8±7.7 years. The prevalence of insomnia, EDS and anemia was 62.1%, 23.8%, and 47.2%, respectively. Insomnia (66.3% vs 58.5%) and EDS (29.6% vs 18.6%) were more common in patients with anemia compared to those without anemia (p<0.05). In univariate analysis, there were significant associations between anemia and insomnia [odds ratio (OR):1.4, 95% confidence interval (CI):1.0-1.9], and EDS (OR:1.8,95% CI:1.3-2.6). In multivariate analysis, the relationship between insomnia and nocturia, chronic obstructive pulmonary disease (COPD), and number of drugs used persisted, whereas being male, of an older age, coronary arterial disease, COPD, Parkinson's disease, dementia, and urinary incontinence were associated with EDS (p<0.05), but there was no significant relationships between anemia and insomnia/EDS (p>0.05).

CONCLUSION

The present data suggests that an elderly who has anemia is 1.4 times more likely to experience insomnia and 1.8 times more likely to experience EDS than those without anemia.