The impact of uric acid levels in the pathophysiology and its contribution to the prediction of diagnosis in restless legs syndrome

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs, worsened in the evening, occurring at rest, and relieved temporarily by movement. Although its pathophysiology remains incompletely understood, oxidative stress has been suggested. Uric acid (UA) is a marker associated with oxidative stress, and its reduced levels pose a risk for certain neurodegenerative diseases. In this study, we aimed to assess serum UA concentrations in RLS patients to gain insights into its role in the etiopathogenesis of the condition.: This study involved 200 individuals. Serum UA levels were compared with clinical parameters. Disease severity was assessed, categorizing patients into "mild," "moderate," "severe," and "very severe" subgroups. Comparative analysis of UA levels was conducted between these subgroups and the control group. Patients exhibited a statistically significant reduction in UA levels compared to controls (p = 0.001; p < 0.01). No significant disparities in UA levels were observed among patients based on RLS scores (p > 0.05). The generalized linear model in which UA serves as the dependent variable revealed statistically significant associations with the "moderate" and "severe" stages of RLS, as well as age (p < 0.05). Additionally, a ROC curve analysis was executed to evaluate the potential of UA as a biomarker. The ROC analysis, focusing on the patient-control classification, revealed a statistically significant area under the curve (AUC = 0.848, p < 0.001). Our study supports the hypothesis implicating serum UA levels in RLS pathogenesis. Further understanding of UA and its physiological effects will clarify on its role in RLS pathophysiology.<br />