Document Type : Original Article

Authors

1 Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran

2 Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Background: Migraine is associated with metabolic syndrome (MetS). There are evidences that components of MetS are more prevalent among migraine patients than non-migraineurs. Since both migraine and MetS are associated with a high risk of cardiovascular events, it is likely that the parameters of MetS increase the occurrence of cardiovascular disease (CVD) in migraineurs. The present research project was conducted for the purpose of investigating the relationship between MetS parameters and different items of migraine headaches.
Methods: This descriptive-analytical, cross-sectional study was performed on 240 migraineurs [according to International Headache Society (HIS) II criteria] within the 17+ age range. The participants were selected via consecutive and convenience sampling method. The evaluated parameters for each subject included 2 arms: migraine characteristics (intensity, frequency of attacks, subtype, duration, and treatment regimen) and indices of MetS according to the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATPIII) report criteria [high-density lipoprotein-cholesterol (‎HDL-C), triglyceride (TG), fasting plasma glucose (FPG), height, waist circumference (WC), systolic and diastolic blood pressure (BP), and body mass index (BMI)]. All data were analyzed in SPSS software.
Results: Total prevalence of MetS was 16.25% (39 patients). There was a statistically meaningful relationship between hypertriglyceridemia and gender (P = 0.021), hypertriglyceridemia and prophylactic antimigraine regimen (P = 0.022), hyperglycemia and age group (P = 0.010), hyperglycemia and the intensity of headache (P = 0.048), hyperglycemia and prophylactic treatment (P = 0.001), systolic hypertension and migraine subtype (P = 0.004), systolic hypertension and the duration of migraine disease (P = 0.005), diastolic hypertension and migraine subtype (P = 0.002), WC and gender (P = 0.001), WC and the intensity of headache (P = 0.028), WC and prophylactic medication (P = 0.017), HDL and gender (P = 0.001), HDL and the prophylactic regimen (P = 0.023), and MetS and gender (P = 0.005). The prevalence of MetS was increased with increase in the severity of migraine headache.
Conclusion: Due to the relative increase in the prevalence of MetS in patients with more severe migraine, an evaluation of the mechanisms of MetS is recommended in this population.

Keywords

  1. Celikbilek A, Celikbilek M, Okur A, Dogan S, Borekci E, Kozan M, et al. Non-alcoholic fatty liver disease in patients with migraine. Neurol Sci 2014; 35(10): 1573-8.
  2. Tsai SS, Chu YY, Chen ST, Chu PH. A comparison of different definitions of metabolic syndrome for the risks of atherosclerosis and diabetes. Diabetol Metab Syndr 2018; 10: 56.
  3. Streel S, Donneau AF, Dardenne N, Hoge A, Albert A, Schoenen J, et al. Screening for the metabolic syndrome in subjects with migraine. Cephalalgia 2017; 37(12): 1180-8.
  4. Di Renzo L, Cammarano A, De Lorenzo A. The missclassification of obesity affects the course of migraine. J Headache Pain 2018; 19(1): 63.
  5. Soleimanpour H, Ghafouri RR, Taheraghdam A, Aghamohammadi D, Negargar S, Golzari SE, et al. Effectiveness of intravenous dexamethasone versus propofol for pain relief in the migraine headache: A prospective double blind randomized clinical trial. BMC Neurol 2012; 12: 114.
  6. Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: A systematic review of population-based studies. Dev Med Child Neurol 2010; 52(12): 1088-97.
  7. Momayyezi M, Fallahzadeh H, Momayyezi M. Prevalence of migraine and tension-type headache in Yazd, Iran. Zahedan J Res Med Sci 2015; 17(4): 966.
  8. Fallahzadeh H, Alihaydari M. Prevalence of migraine and tension-type headache among school children in Yazd, Iran. J Pediatr Neurosci 2011; 6(2): 106-9.
  9. Verrotti A, Di Fonzo A, Agostinelli S, Coppola G, Margiotta M, Parisi P. Obese children suffer more often from migraine. Acta Paediatr 2012; 101(9): e416-e421.
  10. Winsvold BS, Sandven I, Hagen K, Linde M, Midthjell K, Zwart JA. Migraine, headache and development of metabolic syndrome: An 11-year follow-up in the Nord-Trondelag Health Study (HUNT). Pain 2013; 154(8): 1305-11.
  11. Guldiken B, Guldiken S, Taskiran B, Koc G, Turgut N, Kabayel L, et al. Migraine in metabolic syndrome. Neurologist 2009; 15(2): 55-8.
  12. Gozke E, Unal M, Engin H, Gurbuzer N. An observational study on the association between migraines and tension type headaches in patients diagnosed with metabolic syndrome. ISRN Neurol 2013; 2013: 147065.
  13. Ostovar R, Kiani F, Sayehmiri F, Yasemi M, Mohsenzadeh Y, Mohsenzadeh Y. Prevalence of metabolic syndrome in Iran: A meta-analysis. Electron Physician 2017; 9(10): 5402-18.
  14. Shahbazian H, Latifi SM, Jalali MT, Shahbazian H, Amani R, Nikhoo A, et al. Metabolic syndrome and its correlated factors in an urban population in South West of Iran. J Diabetes Metab Disord 2013; 12(1): 11.
  15. Sharifi F, Mousavinasab SN, Saeini M, Dinmohammadi M. Prevalence of metabolic syndrome in an adult urban population of the west of Iran. Exp Diabetes Res 2009; 2009: 136501.
  16. Voss JD, Scher AI. Headache linked with incidence of metabolic syndrome: Comment on migraine, headache and development of metabolic syndrome: An 11-year follow-up in the HUNT study. Pain 2013; 154(8): 1163-4.
  17. Ozcan RK, Ozmen SG. The association between migraine, metabolic syndrome, insulin resistance, and obesity in women: A case-control study. Sisli Etfal Hastan Tip Bul 2019; 53(4): 395-402.
  18. Salmasi M, Amini L, Javanmard SH, Saadatnia M. Metabolic syndrome in migraine headache: A case-control study. J Res Med Sci 2014; 19(1): 13-7.
  19. Fava A, Pirritano D, Consoli D, Plastino M, Casalinuovo F, Cristofaro S, et al. Chronic migraine in women is associated with insulin resistance: A cross-sectional study. Eur J Neurol 2014; 21(2): 267-72.
  20. Santos IS, Goulart AC, Passos VM, Molina MC, Lotufo PA, Bensenor IM. Obesity, abdominal obesity and migraine: A cross-sectional analysis of ELSA-Brasil baseline data. Cephalalgia 2015; 35(5): 426-36.
  21. Sachdev A, Marmura MJ. Metabolic syndrome and migraine. Front Neurol 2012; 3: 161.
  22. Winter AC, Wang L, Buring JE, Sesso HD, Kurth T. Migraine, weight gain and the risk of becoming overweight and obese: A prospective cohort study. Cephalalgia 2012; 32(13): 963-71.
  23. Dalvand S, Niksima SH, Meshkani R, Ghanei GR, Sadegh-Nejadi S, Kooti W, et al. Prevalence of metabolic syndrome among Iranian population: A systematic review and meta-analysis. Iran J Public Health 2017; 46(4): 456-67.
  24. Peterlin BL, Rosso AL, Rapoport AM, Scher AI. Obesity and migraine: the effect of age, gender and adipose tissue distribution. Headache 2010; 50(1): 52-62.
  25. Kokavec A. Migraine: A disorder of metabolism? Med Hypotheses 2016; 97: 117-30.
  26. Mancia G, Rosei EA, Ambrosioni E, Avino F, Carolei A, Dacco M, et al. Hypertension and migraine comorbidity: prevalence and risk of cerebrovascular events: Evidence from a large, multicenter, cross-sectional survey in Italy (MIRACLES study). J Hypertens 2011; 29(2): 309-18.
  27. Barbanti P, Aurilia C, Egeo G, Fofi L. Hypertension as a risk factor for migraine chronification. Neurol Sci 2010; 31(Suppl 1): S41-S43.
  28. Delavari A, Forouzanfar MH, Alikhani S, Sharifian A, Kelishadi R. First nationwide study of the prevalence of the metabolic syndrome and optimal cutoff points of waist circumference in the Middle East: The national survey of risk factors for noncommunicable diseases of Iran. Diabetes Care 2009; 32(6): 1092-7.
  29. Ansarimoghaddam A, Adineh HA, Zareban I, Iranpour S, HosseinZadeh A, Framanfarma K. Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies. Diabetes Metab Syndr 2018; 12(2): 195-201.
  30. Kalan FK, Kaykhaei MA, Adineh HA, Mohammadi M, Dabiri S, Ansari-Moghaddam A. Prevalence of metabolic syndrome in Iran: A meta-analysis of 69 studies. Diabetes Metab Syndr 2019; 13(1): 792-9.
  31. Andreeva VA, Galan P, Julia C, Fezeu L, Hercberg S, Kesse-Guyot E. A systematic literature review of observational studies of the bidirectional association between metabolic syndrome and migraine. Diabetes Metab 2019; 45(1): 11-8.
  32. He Z, Dong L, Zhang Y, Kong Q, Tan G, Zhou J. Metabolic syndrome in female migraine patients is associated with medication overuse headache: A clinic-based study in China. Eur J Neurol 2015; 22(8): 1228-34.
  33. Harandi SA, Togha M, Sadatnaseri A, Hosseini SH, Jahromi SR. Cardiovascular risk factors and migraine without aura: A case-control study. Iran J Neurol 2013; 12(3): 98-101.
  34. Tarantino G, Finelli C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome? World J Gastroenterol 2013; 19(22): 3375-84.
  35. Verrotti A, Di FA, Penta L, Agostinelli S, Parisi P. Obesity and headache/migraine: the importance of weight reduction through lifestyle modifications. Biomed Res Int 2014; 2014: 420858.
  36. Bond DS, Roth J, Nash JM, Wing RR. Migraine and obesity: Epidemiology, possible mechanisms and the potential role of weight loss treatment. Obes Rev 2011; 12(5): e362-e371.
  37. Gardener H, Monteith T, Rundek T, Wright CB, Elkind MS, Sacco RL. Hypertension and Migraine in the Northern Manhattan Study. Ethn Dis 2016; 26(3): 323-30.
  38. Rist PM, Winter AC, Buring JE, Sesso HD, Kurth T. Migraine and the risk of incident hypertension among women. Cephalalgia 2018; 38(12): 1817-24.
  39. Tana C, Tafuri E, Tana M, Martelletti P, Negro A, Affaitati G, et al. New insights into the cardiovascular risk of migraine and the role of white matter hyperintensities: is gold all that glitters? J Headache Pain 2013; 14: 9.
  40. Bhoi SK, Kalita J, Misra UK. Metabolic syndrome and insulin resistance in migraine. J Headache Pain 2012; 13(4): 321-6.
  41. Saberi A, Hatamian HR, Kazemnejad E, Ghorbannejad N. Hyperlipidemia in migraine: Is it more frequent in migraineurs? Iran J Neurol 2011; 10(3-4): 46-50.