Objective: To evaluate clinical characteristics, iron status, and metabolic comorbidities in patients with Restless Legs Syndrome (RLS) and examine associations between peripheral iron parameters and disease expression

Background: RLS is a sensorimotor disorder characterized by an urge to move the limbs, worsening at rest and during evening hours. Iron deficiency and dopaminergic dysfunction are central to its pathophysiology, yet peripheral ferritin does not consistently reflect central nervous system iron status. Metabolic disorders such as diabetes and systemic inflammation may further influence symptom persistence and severity. Data from Indian tertiary-care populations remain limited

Method: We conducted a hospital-based observational study of consecutive patients fulfilling International Restless Legs Syndrome Study Group diagnostic criteria. Demographic features, symptom profile, family history, and comorbidities were recorded. Laboratory evaluation included hemoglobin and serum ferritin along with metabolic parameters. Clinical severity was assessed using standardized measures. Descriptive and comparative analyses evaluated relationships between iron indices, comorbidities, and symptom burden

Results: RLS predominantly affected middle-aged adults with female preponderance. A substantial proportion had normal peripheral ferritin despite clinically significant symptoms, suggesting discordance between systemic iron stores and central mechanisms. Iron deficiency, when present, correlated with greater symptom burden. Metabolic comorbidities, particularly diabetes mellitus, were frequent and associated with persistent or moderate-to-severe disease. Familial clustering was observed in a subset, supporting genetic susceptibility

Conclusion: These findings reinforce the multifactorial nature of RLS and highlight limitations of peripheral ferritin as a standalone biomarker. The coexistence of metabolic disease suggests broader inflammatory–metabolic contributions to RLS pathophysiology. Comprehensive evaluation of iron parameters and cardiometabolic risk factors may improve diagnostic accuracy and individualized management strategies

Baseline Demographics and Clinical Features

Comorbidity Association with Iron Deficiency

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MDS Abstracts - https://www.mdsabstracts.org/abstract/iron-dysregulation-and-metabolic-inflammation-in-restless-legs-syndrome-clinical-correlates-from-a-tertiary-hospital-cohort/