PROSPECTIVE STUDY OF IRON METABOLISM AND RLS IN BLOOD DONORS L. Lillo-Triguero1, A. Guillem2, A. Del Castillo3, I.Valdés3, R. Del Río4, R. Peraita-Adrados5. Neurology Alcorcón Fundation University Hospital1, Neurology2 Internal Medicine 3 and Sleep Unit-Clinical Neurophysiology5 Departments Gregorio Marañón University Hospital. Madrid Spain 4 Sleep Unit-Clinical Neurophysiology, La Paz University Hospital. Madrid. Spain RLS is strongly linked to iron deficiency . Regular blood donation may lead to iron deficiency. Previous results in the literatur are contradictory, with some studies suggesting an increased risk of RLS in blood donors (1,2), and others which failed to find any relation (3,4). However this kind of study has not been replicated in Spain were blood donation is altruistic and tightly regulated INTRODUCTION We designed a prospective study in two Blood Donation Units of the Public Health System of the Community of Madrid to study iron metabolism, and the presence of RLS symptoms in blood donors. AIM OF THE STUDY SAMPLE CHARACTERISTICS METHODS - 179 blood donors, 101 women (56%), and 78 men (44%) - Mean age: 43.18 years IC95% (41.46-44.90) - Mean BMI: 25.86 kg/m2 IC95% (25.20-26.52) - Blood donors were divided into: 1. first time donors (n=44, 24.58%) 2. regular blood donors (n=135, 75.42%) : - Mean years donation 10.88 IC95% (9.29-12.47) - Mean number donations/year 2.059 IC95% (1.89-2.23) All blood Donors undergo a Physical examination, including: Blood pressure BMI Capillary Haemoglobin test (discarding for donation those with HB<12 gr/dl) The study was approved by both Ethics Committees Sample recruitment, after signing the Informed Consent underwent: An aditional blood test where we determinate serum ferritin. Answered a brief questionary of 4 questions for the assessment of RLS: - Do you have uncomfortable or unpleasant sensations in the legs such us laying down or sitting? - Does movement, such as walking or stretching, relieves the unpleasant sensations in the legs partially or totally? - This unpleasant sensations during rest or inactivity only occur or are worse in the evening or night - Does the unpleasant sensations enables you to sleep? RESULTS FERRITIN VS BMI We found, as expected, a significant positive correlation between ferritin values and BMI (p< 0.01) RESULTS 4 RLS questions RESULTS GENDER DIFERENCES Twenty-eight (15.4%, 18 women) blood donors answered yes to at least one of the questions: 4 (2%) 1 question 9 (4.5%) 2 questions 10 (5%) 3 questions 5 (2.5%) 4 questions Women (12-200 µg/L ) Men (26-370 µg/L) Mean ferritin 48.69µg/L IC95% (40.05-57.33) 131.81 µg/L IC95% (110.06-153.5) P < 0.01 YES NO 1. Unpleaseant sensations during rest 28 (15.6%) 151 (84.4%) 2. Relieved by movement 22 (12.3%) 157 (87.7%) 3. Worsen in the evening 15 (8.4%) 164 (91.6%) 4. Sleep disturbance 7 (3.9%) 172 (96.1%) RESULTS FIRST TIME VS REGULAR DONORS First time donors Regular donors Mean ferritin 136.47 µg/L IC95% (101.89-171.05) 79.72 µg/L IC95% (67.60-91.83) P=0.007 Women had a higher risk to have at least one RLS symptom when adjusted for all variables (age, ferritin, BMI, first or regular donors), p=0,053 We do not find any association between ferritin and RLS symptoms (p=0.97) We do not find association between ferritin < 50 µg /L and RLS symptoms (p=0.88) RESULTS FERRITIN < 50µg/L 79 donors (44.4%) with ferritin < 50 µg /L, with predominance of women and regular donors, this was statisticaly significant 7 donors (4%), (5 F/ 2M) had ferritin < 12 µg /L, all of them Regular donors CONCLUSIONS Regular blood donation, when regulated in similar conditions as in Spain, reduces iron stores to ferritin concentration < 50 µg/L but does not increase the risk of RLS symptoms Women donors have lower ferritin values, and a higher risk to have, at least, one RLS symptom.. Women Men First Time donors Regular donors Ferritin < 50 µg /L 50 (64.9%) *p < 0.01 29 (28.7%) 13 (29.5%) 66 (49.3%) * p=0.02 Ulfberg J, Nyström B. Restless legs syndrome in blood donors. Sleep Med 2004;5(2):115-8 Allan S, Haba-Rubio J. Fréquence et sévérité du syndrome des jambes sans repos après don de sang: une étude cas-témoins. Méd du sommeil 2010;7(4):156-60 Burchell BJ, Allen RP, et al. RLS and blood donation. Sleep Med 2009;10(8):944-9 Arunthari MD,Kaplan J, el al.Prevalence of Restless Legs Syndrome in Blood Donors.Mov Disor 2010;25(10):1451-5 Our sincere acknowledgment to all the colleagues that colaborated in the study: E. Luque, N. Redondo, B. Chavarría, M. Vales, M. Clavero, N. Matskiv, M. Cortés, A. Navarro, J. Anguita,