Verrotti A, Carotenuto M, Altieri L, Parisi P, Tozzi E, Belcastro V, Esposito M, Guastaferro N, Ciuti A, Mohn A, Chiarelli F, Agostinelli S
Department of Pediatrics, University of Perugia, Perugia, Italy.
Pediatr Obes. 2015 Jun;10(3):220-5. doi: 10.1111/ijpo.245. Epub 2014 Jul 3.
Weight loss can determine significant improvement of migraine in obese patients. Herein, we evaluated a clinical sample of adolescent migraineurs with obesity who participated in an interdisciplinary programme for weight loss, in order to identify possible metabolic parameters associated with good migraine control.
Using a cross-sectional design, we evaluated 112 out of 135 adolescents who previously underwent our intervention programme. Based on persistence of headache, subjects for comparison were 40 migraine-free and 72 not migraine-free adolescents. Participants underwent anthropometric evaluations and biochemical tests.
Patients with persistence of migraine had significantly higher weight (P < 0.01), body mass index (P < 0.01), waist circumference (P < 0.01), homeostasis model assessment of insulin resistance (P < 0.001), triglyceride (P < 0.05), total cholesterol (P < 0.05) and low-density lipoprotein cholesterol (P < 0.05) values when compared with those who became migraine-free. Between potential predictors, only insulin resistance (odds ratio = 3.5, 95% confidence interval = 1.4-6.1; P < 0.001) was significantly associated with persistence of migraine after intervention programme.
Among obese adolescents with migraine who underwent an intervention programme for weight loss, patients who did not become migraine-free showed higher adiposity values than those who became migraine-free. Patients with insulin resistance had 3.5 times the odds of having persistence of migraine compared with those without.
体重减轻可显著改善肥胖患者的偏头痛症状。在此,我们评估了一组参与跨学科减肥计划的肥胖青少年偏头痛患者的临床样本,以确定可能与偏头痛良好控制相关的代谢参数。
采用横断面设计,我们评估了135名曾参加我们干预计划的青少年中的112名。根据头痛的持续情况,将40名无偏头痛青少年和72名仍有偏头痛的青少年作为比较对象。参与者接受了人体测量评估和生化测试。
与无偏头痛的患者相比,仍有偏头痛的患者体重(P < 0.01)、体重指数(P < 0.01)、腰围(P < 0.01)、胰岛素抵抗稳态模型评估值(P < 0.001)、甘油三酯(P < 0.05)、总胆固醇(P < 0.05)和低密度脂蛋白胆固醇(P < 0.05)显著更高。在潜在预测因素中,干预计划后只有胰岛素抵抗(优势比=3.5,95%置信区间=1.4-6.1;P < 0.001)与偏头痛的持续存在显著相关。
在接受减肥干预计划的肥胖青少年偏头痛患者中,仍有偏头痛的患者比无偏头痛的患者肥胖值更高。与无胰岛素抵抗的患者相比,有胰岛素抵抗的患者偏头痛持续存在的几率是其3.5倍。