The association between migraine, metabolic syndrome, insulin resistance, and obesity in women: Case-control study

Abstract

M igraine headache is a complicated, repetitive headache disorder that is a very pervasive complaint in neurology. The overall prevalence is 5% to 15%, [1, 2] and it is more frequent among females than males. [3] Migraines are thought to be related to various comorbid disorders, such as epilepsy, depression, anxiety, ischemic stroke, Raynaud's phenomenon, iron deficiency anemia, obesity, insulin resistance (IR), and metabolic syndrome. [4-6] However, the relationship between migraines and these comorbid disorders is not yet clear, [7] particularly any association with obesity, IR, or metabolic syndrome. Some researchers have found an association between metabolic syndrome and migraine; [4, 8] however other studies have had different results. [9] Guldiken et al. [4] found that Objectives: The aim of this study was to examine the relationship between migraines and obesity, insulin resistance (IR), and metabolic syndrome in female migraineurs. Methods: A total of 141 female patients who experience migraines and a control group of 141 sex-and age-matched individuals who do not were enrolled in this case-control study. The migraine group was composed of patients from the Gebze Fatih Community Hospital (Kocaeli, Turkey) neurology outpatient service and the control group included hospital staff and friends who volunteered to participate. Descriptive statistics and multivariate logistic regression analyses were performed. Migraine was designated as a dependent variable. Family history of migraine, stroke, metabolic syndrome, cardiac disease, hypertension, hyperlipidemia, and diabetes mellitus; cigarette use; alcohol consumption; and the presence of hypertension, IR, hypertriglyceridemia, low level of high-density lipoprotein (HDL), central obesity, metabolic syndrome; as well as homeostasis model assessment and quantitative insulin sensitivity check index results were selected as independent variables. Results: The mean waist circumference, mean height, mean weight, and central obesity were greater in the control group (p=0.009, 0.004, 0.036, and 0.015, respectively). A multivariate logistic regression model of migraine presence showed that a family history of migraine (odds ratio [OR]: 1.542, 95% confidence interval [CI]: 2.451-8.905; p<0.0001), family history of stroke (OR: 1.043, 95% CI: 1.214-6.633; p=0.016), and no central obesity (OR:-0.705, 95% CI:-0.290-0.843; p=0.010) were statistically significant variables in our study. Conclusion: The results of our study indicated that IR and metabolic syndrome were not associated with migraine in women. There was an inverse relationship between central obesity and migraine. Additional research with larger participant groups should be performed to further explore the complex relationship between migraine, obesity, IR, and metabolic syndrome.

Plasma Lipolysis and Changes in Plasma and Cerebrospinal Fluid Signaling Lipids Reveal Abnormal Lipid Metabolism in Chronic Migraine

“…Thus, the higher levels of plasma UFAs in CM may suggest an enhanced activation of lipolytic pathways. Since the balance of glucagon/catecholamines and insulin controls lipolysis, insulin resistance is suggested to be associated with migraine pathophysiology ( Fava et al, 2014 ; Ozcan and Ozmen, 2019 ) may also account for the higher levels of UFAs in CM plasma.…”

“…We summarize the implication of these changes in Table 2 . The physiological implications include energy production ( Lindsay, 1975 ; Jumpertz et al, 2012 ; Nakamura et al, 2014 ; Alcock and Lin, 2015 ; Cucchi et al, 2019 ), the trigger of the inflammatory response through via TLR4 signaling pathway associated with pain pathogenesis ( Zhang and Ma, 2017 ), worsening pain ( Sekar et al, 2020 ), and a link to insulin resistance that is proposed to be a part of migraine pathophysiology ( Rao and Pearce, 1971 ; Perciaccante and Perciaccante, 2008 ; Bhoi et al, 2012 ; Ozcan and Ozmen, 2019 ). The levels and de novo synthesis of SAFAs are linked with CNS and peripheral nervous system myelination ( Salles et al, 2002 ; Montani et al, 2018 ; Dimas et al, 2019 ), and fatty acid elongation is increased during active myelination in rodents ( Morita et al, 2015 ).…”

Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus

“…Insulin resistance (IR) has been proposed as an underlying pathophysiological mechanism involved in the association between migraine and diabetes ( 173 ), although not all studies found this link ( 174 ). Migraine patients have been reported to have increased insulin levels compared to controls ( 175 , 176 ).…”

Association of altered serum glucose and lipid profiles with headaches in young women: clinical, cross-sectional study

“…16 Low levels of vitamin D have been shown to increase the risk of various health conditions, including metabolic disorders, autoimmune diseases, and cardiovascular diseases 17,18 . Research has suggested a possible association between migraine and low levels of vitamin D 19 , hypercholesterolemia, high blood glucose 5 , hypertension 20 , insulin resistance, diabetes 21 , anthropometric measurements, including body mass index (BMI) and waist circumference. 22,23 However, the association between migraines is not well established, and further research is required to determine the exact mechanism underlying this relationship.…”

“…Nonetheless, a study indicated that insulin resistance and metabolic syndrome were not associated with migraine in women and was an inverse relationship between central obesity and migraine. 21 Most studies involving the migraine have been performed in predominantly populations if aged mean of 40-60 years. Little is known about the involving young women, especially Brazilian young women.…”