Insulin Metabolism is Altered in Migraineurs: A New Pathogenic Mechanism for Migraine?

Cavestro, Cinzia; Rosatello, Annalisa; Micca, Gianmatteo; Ravotto, Marisa; Marino, Maria; Asteggiano, Giovanni; Beghi, Ettore

doi:10.1111/j.1526-4610.2006.00719.x

Cited by 24 publications

(32 citation statements)

References 24 publications

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“…Furthermore, components of the metabolic syndrome are comorbid with migraine. 37 Our study has limitations. First, headache diagnoses were based on questionnaires and not on in-person clinical assessment.…”

Section: Discussionmentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal¹,

Kurth

Santanello³

et al. 2010

Neurology

318

270

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Objectives: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. Methods:In this case-control study, migraineurs (n ϭ 6,102) and controls (n ϭ 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. Results:In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98 -3.23). Conclusion:Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established. Neurology ® 2010;74:628 -635

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Section: Discussionmentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal¹,

Kurth

Santanello³

et al. 2010

Neurology

318

270

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“…48 A recent study measured insulin and glucose levels in individuals with migraine, individuals with other headaches, and controls. 49 Tests were conducted at fasting and after an oral glucose tolerance test. Compared to controls, migraineurs had significantly higher levels of glucose and of insulin, at fasting and after glucose loading.…”

mentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal¹,

Kurth

Hu³

et al. 2009

Neurology

166

135

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Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA. Neurology ® 2009;72:1864-1871 GLOSSARY BMI ϭ body mass index; CDH ϭ chronic daily headache; CI ϭ confidence interval; CSD ϭ cortical spreading depression; CVD ϭ cardiovascular disease; EPC ϭ endothelial progenitor cells; HR ϭ hazard ratio; MA ϭ migraine with aura; MMP ϭ matrix metalloproteinase; MO ϭ migraine without aura; MTHFR ϭ methyltetrahydrofolate reductase; RR ϭ relative risk.

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“…84 migren, 25 baş ağrısı hastası ve 26 kontrol grubu ile glukoz ve insulin konsantrasyonlarını karşılaştırmıştır. 16 Genel ola-rak glukozdaki yükselme baş ağrısı ile ilişkili ve artmış insülin düzeyi özellikle migren atakları ile iliş-kili bulunmuştur.…”

Section: Açlik Gli̇koz Metaboli̇zmasi Ve Mi̇grenunclassified

The Relationship Between Frequency, Duration and Intensity of Migraine Attacks and Nutrition

Oğuz¹,

Güneş²,

Öğren³

2018

Turkiye Klinikleri J Health Sci

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Ö ÖZ ZE ET T Migren normal duyusal olayların anormal beyin işlemesi nedeniyle sinir sisteminin aşırı duyarlı olması sonucu oluşan poligenetik bir hastalıktır. Dünya Sağlık Örgütü (DSÖ) yaşam şartlarını etkileyen en engelleyici kronik hastalıklarından biri olarak migreni görmektedir. Beslenme, hormonal ve çevresel faktörler duyarlı bireylerde migreni tetikleyebilir. Stres, hormonal değişiklikler, psikolojik yönler, yorgunluk, uyku süresinde dengesizlikler, ilaçlar ve tütün kullanımı, kokulara hassasiyet, egzersiz, ışık, iklim değişikliği ve yüksek rakım migreni artıran faktörlerdir. Migren ve beslenme arasında karmaşık bir ilişki mevcuttur. Besinsel tetikleyici faktörler halen tartışmalı bir konudur ve değerlendirilmesi bireysel farklılıklar nedeniyle oldukça zordur. Genel olarak açlık veya öğün atlama ciddi bir tetikleyici olmakla beraber çikolata, kırmızı şarap, peynir, kafein, monosodyum glutamat (MSG), nitrit ve aspartam önemli tetikleyiciler olarak karşımıza çıkmaktadır. Yapılan yeni çalışmalarda migren tedavisinde ek olarak magnezyum, riboflavin, koenzim Q10 gibi bazı fonksiyonel besinlerin kullanımının migren ataklarının sıklığını, şiddetini ve süresini azaltıla-bileceği bulunmuştur. Migrenin alerji ile ilişkili olduğu düşünülerek, alerji oluşturan besinlerin diyetten çıkarılmasını kapsayan eliminasyon diyetleri gündeme gelmiştir. Beden Kitle İndeksi (BKİ) ve migren özellikleri arasındaki ilişki çelişkili olmasına rağmen çok zayıf ve kilolu olmanın migren nöbetlerini tetikleyebileceğini gösteren bazı çalışmalar mevcuttur. Bu çalışmanın amacı, yapılmış güncel çalışmalar ışığında migreni tetikleyen besinler ve bu besinler ile migren nöbetlerinin şiddeti, yoğunluğu ve süresi arasındaki ilişkileri incelemektir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Migren hastalığı; beslenme tedavisi

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Insulin Metabolism is Altered in Migraineurs: A New Pathogenic Mechanism for Migraine?

Cited by 24 publications

References 24 publications

Migraine and cardiovascular disease

Migraine and cardiovascular disease

Migraine and cardiovascular disease

The Relationship Between Frequency, Duration and Intensity of Migraine Attacks and Nutrition

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