Blood zonulin levels in restless legs syndrome: insights into intestinal permeability

Zonulin is a protein, synthesized in intestinal cells, that reversibly regulates the permeability of the intestinal epithelium. Elevated levels of zonulin are associated with increased intestinal permeability. It is shown that some neurological disorders are related to zonulin. We aim to research the possible associations between the zonulin levels and the symptom intensity in restless legs syndrome.

Demographic data of 43 patients with restless legs syndrome were recorded, and plasma zonulin levels were compared with 43 healthy controls using the enzyme-linked immunosorbent assay test. In the study, 66% of all participants were female and 20% were male. The mean age of the study group was 57.4±14.3 years. The average duration of the disease was 9.3±7.4 years, while the severity of the disease was 24.3±7.6. A p<0.05 was considered statistically significant.

There was no significant difference between plasma zonulin levels in the control group and patients, but there were more individuals in the patient group in the high category of Zonulin levels, while the control group was dominant in the low level. In the patient group, zonulin levels were higher in the overweight and obese groups according to body mass index.

Our study indirectly supports the hypothesis that central factors play a more significant role in the pathophysiology of restless legs syndrome rather than immunoresponsiveness in the gut and intestinal permeability.