体重指数与发作性头痛：一项基于人群的研究。

Body mass index and episodic headaches: a population-based study.

作者信息

Bigal Marcelo E, Tsang Amy, Loder Elizabeth, Serrano Daniel, Reed Michael L, Lipton Richard B

机构信息

Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.

出版信息

Arch Intern Med. 2007 Oct 8;167(18):1964-70. doi: 10.1001/archinte.167.18.1964.

DOI:10.1001/archinte.167.18.1964

PMID:17923596

Abstract

BACKGROUND

We investigated the influence of the body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]) on the frequency, severity, and patterns of treatment of migraine, probable migraine (PM), and severe episodic tension-type headache (S-ETTH).

METHODS

A validated questionnaire was mailed to 120 000 households selected to be representative of the US population. The participants were divided into 5 categories based on BMI: underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), obese (30.0-34.9), and morbidly obese (>35.0). Analyses were adjusted by covariates that included demographic variables (age, sex, race, and income), duration of illness, comorbidities, use of preventive medication, and use of opioids.

RESULTS

The response rate was 65%. We identified 18 968 individuals with migraine, 7564 with PM, and 2051 with S-ETTH. The distribution of very frequent headaches (10-14 d/mo) was assessed by BMI. Among individuals with migraine, very frequent headaches (10-14 d/mo) occurred in 7.4% of the overweight (P = .10), 8.2% of the obese (P < .001), and 10.4% of the morbidly obese (P < .0001) subjects, compared with 6.5% of those with normal weight, in adjusted analyses. Among individuals with PM and S-ETTH, the differences were not significant (P = .20). The disability of migraineurs, but not of those with PM or S-ETTH, also varied as a function of BMI. Among migraineurs, 32.0% of those with normal weight had some disability compared with 37.2% of the overweight (P < .01), 38.4% of the obese (P < .001), and 40.9% of the morbidly obese (P < .001) subjects.

CONCLUSION

These findings support the concept that obesity is an exacerbating factor for migraine but not for other types of episodic headaches.

摘要

背景

我们研究了体重指数（BMI，计算方法为千克体重除以米平方身高）对偏头痛、可能偏头痛（PM）和重度发作性紧张型头痛（S-ETTH）的发作频率、严重程度及治疗模式的影响。

方法

向120000户被选为代表美国人口的家庭邮寄了一份经过验证的问卷。参与者根据BMI分为5类：体重过轻（<18.5）、正常体重（18.5 - 24.9）、超重（25.0 - 29.9）、肥胖（30.0 - 34.9）和病态肥胖（>35.0）。分析通过协变量进行调整，协变量包括人口统计学变量（年龄、性别、种族和收入）、病程、合并症、预防性药物使用情况和阿片类药物使用情况。

结果

应答率为65%。我们确定了18968例偏头痛患者、7564例可能偏头痛患者和2051例重度发作性紧张型头痛患者。通过BMI评估了非常频繁头痛（每月10 - 14天）的分布情况。在偏头痛患者中，经调整分析后，超重者中非常频繁头痛（每月10 - 14天）的发生率为7.4%（P = 0.10），肥胖者为8.2%（P < 0.001），病态肥胖者为10.4%（P < 0.0001），而正常体重者为6.5%。在可能偏头痛和重度发作性紧张型头痛患者中，差异不显著（P = 0.20）。偏头痛患者的残疾情况（而非可能偏头痛或重度发作性紧张型头痛患者）也随BMI而变化。在偏头痛患者中，正常体重者中有32.0%有某种残疾，超重者为37.2%（P < 0.01），肥胖者为38.4%（P < 0.001），病态肥胖者为40.9%（P < 0.001）。