Exploring the association between hypocretin-1 levels and bone mineral content in patients with narcolepsy: A cross-sectional study

• Published in: Sleep medicine Vol. 121; pp. 375 - 378
• Main Authors: Reis, Maria Júlia Figueiró, Truzzi, Giselle de Martin, Naufel, Maria Fernanda, Coelho, Fernando Morgadinho Santos
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2024
• Subjects: Bone mineral mass; Hypocretin-1; Narcolepsy; Nutrition; Obesity; Bone mineral mass; Obesity; Narcolepsy; Hypocretin-1; Nutrition
• ISSN: 1389-9457; 1878-5506; 1878-5506
• DOI: 10.1016/j.sleep.2024.07.026

Recent studies suggest the existence of a physiologic basis for bone rarefaction and increased risk for fractures. This study aimed to address anthropometric differences between patients with narcolepsy type 1 (NT1) and type 2 (NT2) and discrepancies in bone mineral content (BMC) as a function of hypocretin-1 (Hcrt-1) measured in cerebrospinal fluid (CSF). We have evaluated 31 adult patients (aged 18–65 years) with NT1 and 18 patients with NT2, comparing the groups in terms of anthropometric variables – body mass index (BMI) and waist-to-hip ratio (WHR) – and percentage of bone mineral content (%BMC), measured by bioelectrical impedance analysis (BIA). Statistical analysis assessed the effects of Hcrt-1 levels on CSF, dietary intake, and medication use over these variables. Statistical significance was achieved with a confidence interval of 95 % and p < 0.05. Patients with NT1 presented with higher BMI (32.04 ± 6.95 vs. 25.38 ± 4.26 kg/m2; p < 0.01) and WHR (0.89 ± 0.09 vs. 0.83 ± 0.09; p = 0.02) compared to NT2, in detriment of %BMC, which was lower for NT1 (4.1 ± 1.02 vs. 4.89 ± 0.59; p < 0.01). Hcrt-1 in CSF showed a positive correlation with %BMC (r = +0.48, p < 0.01) and a negative correlation with anthropometric features (BMI: r = −0.54, p < 0.01; WHR: r = −0.37, p = 0.01). There was a correlation between WHR and diary caloric intake (r = +0.42, p < 0.01). The evaluation of patients with narcolepsy presupposes a syndromic approach comprising symptoms that go far beyond excessive daytime sleepiness. The integrated follow-up, including nutritional profile and anthropometric features, should add value in reducing morbidity in this population. •NT1 with low hypocretin-1 levels is associated with weight gain.•NT1 with low hypocretin-1 levels is potentially related to bone rarefaction.•There is a possible positive correlation between hypocretin-1 level and bone mass.•Monitoring bone mass can impact the well-being of patients with narcolepsy.