Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus

Abstract

Migraine is a disabling neurovascular disorder, characterized by moderate to severe unilateral headaches, nausea, photophobia, and/or phonophobia, with a higher prevalence in women than in men, which can drastically affect the quality of life of migraine patients. In addition, this chronic disorder is related with metabolic comorbidities associated with the patient's lifestyle, including obesity and diabetes mellitus (DM). Beyond the personal and socioeconomic impact caused by migraine, obesity and DM, it has been suggested that these metabolic disorders seem to be related to migraine since: (i) they are a risk factor for developing cardiovascular disorders or chronic diseases; (ii) they can be influenced by genetic and environmental risk factors; and (iii) while clinical and epidemiological studies suggest that obesity is a risk factor for migraine, DM (i.e., type 1 and type 2 DM) have been reported to be either a protective or a risk factor in migraine. On this basis, and given the high worldwide prevalence of migraine, obesity, and DM, this article provides a narrative review of the current literature related to the association between the etiology and pathophysiology of migraine and these metabolic disorders, considering lifestyle aspects, as well as the possible involvement of neurotransmitters, neuropeptides, and/or sex hormones. While a link between migraine and metabolic disorders has been suggested, many studies are contradictory and the mechanisms involved in this association are not yet sufficiently established. Therefore, further research should be focused on understanding the possible mechanisms involved.

Applying a biopsychosocial model to migraine: rationale and clinical implications

“…A higher-than-expected frequency of several diseases has been reported in migraine, often with a bidirectional association [ 49 – 56 ] (Fig. 3 ).…”

“…Regarding the first postulated explanation, we can provide the example of psychiatric comorbidities, epilepsy, or sleep disturbances [ 57 – 59 ]. Regarding the second postulated explanation, we can include obesity and inflammatory diseases [ 56 , 60 – 62 ]. Irrespectively of the presence or not of shared mechanisms, it is a fact that several treatments which are commonly used for migraine prophylaxis have been repurposed from other diseases.…”

“…As shown by the results of a recent meta-analysis [ 49 ], the pooled prevalence of arthritis, fibromyalgia and back pain was, respectively, 12% (95% CI: 9–16%), 26% (95% CI: 8–50%), and 46% (95% CI: 20–72%). Rheumatologic diseases are characterized by the presence of systemic inflammation, which could potentiate the neurogenic inflammation of migraine mediated by peripheral CGRP release, and mast cell degranulation [ 56 ]. Additionally, many rheumatologic diseases are associated with pain, which could contribute to central sensitization and further worsening of migraine [ 83 , 84 ].…”

A Digital Health Application Allowing a Personalized Low-Glycemic Nutrition for the Prophylaxis of Migraine: Proof-of-Concept Data from a Retrospective Cohort Study

“…It is debated whether and how diabetes mellitus and migraine may be interrelated [49]. Epidemiological data suggest that diabetes is less frequent in migraine patients and vice versa [50].…”

Associations between Zygoma Fracture and Post-Traumatic Headache: A Study among Taiwanese Population

“…To minimize the influences of confounding factors, we paired each patient with zygoma fracture with one patient in the unexposed group with propensity score matching. The confounding factors include age, sex, index year, and comorbidities such as hypertension (codes 401-405) [10], diabetes (code 250) [11], hyperlipidemia (ICD-9-CM: 272) [12], subdural hemorrhage (ICD-9-CM: 432.1) [13], obesity (ICD-9-CM: 278) [14], alcoholism (ICD-9-CM: 291, 303, 305, and V113) [15], and depression (ICD-9-CM: 296.2, 296.3, 296.82, 300.4, 309.0, 309.1, 309.28, and 311) [11].…”