Tsai Min-Juei, Chen Yung-Tai, Ou Shuo-Ming, Shin Chia-Jen, Peng Kuan-Po, Tang Chao-Hsiun, Wang Shuu-Jiun
Department of Internal Medicine, Taipei Veterans General Hospital, Suao Branch, Taiwan National Yang-Ming University School of Medicine, Taiwan.
National Yang-Ming University School of Medicine, Taiwan Department of Nephrology, Institute of Internal Medicine, Taipei City Hospital Heping Fuyou Branch, Taiwan.
Cephalalgia. 2015 Jul;35(8):652-61. doi: 10.1177/0333102414553825. Epub 2014 Oct 15.
Whether migraine is associated with urinary calculi is an unresolved issue, although topiramate, a migraine-preventive agent, is known to contribute to this complication. This study investigates the association between migraine and the risk of urinary calculi.
We identified a total of 147,399 patients aged ≥18 years with migraine diagnoses recorded in the Taiwan National Health Insurance Research Database between 2005 and 2009. Each patient was randomly matched with one individual without headache using propensity scores. All participants were followed from the date of enrollment until urinary calculi development, death, or the end of 2010.
The risk of urinary calculi was greater in the migraine than the control cohort (adjusted hazard ratio (aHR), 1.58; 95% confidence interval (CI), 1.52-1.63; p < 0.001, irrespective of the influence of topiramate. The risk was higher in younger and female patients. The magnitude of the risk was proportional to the annual frequency of clinic visits for headache (≥6 vs. <3, aHR = 1.11; 95% CI, 1.04-1.17; p = 0.002), but did not differ between migraine patients with and without aura.
Our study showed migraine was associated with an increased risk of urinary calculi, independent of topiramate use. A higher frequency of clinic visits was associated with a greater risk.
尽管已知偏头痛预防性药物托吡酯会导致尿结石这一并发症,但偏头痛是否与尿结石相关仍是一个未解决的问题。本研究调查偏头痛与尿结石风险之间的关联。
我们在台湾国民健康保险研究数据库中识别出2005年至2009年间记录的总共147399名年龄≥18岁且诊断为偏头痛的患者。使用倾向得分将每位患者与一名无头痛的个体进行随机匹配。所有参与者从入组日期开始随访,直至发生尿结石、死亡或2010年底。
偏头痛队列中尿结石的风险高于对照组(调整后风险比(aHR)为1.58;95%置信区间(CI)为1.52 - 1.63;p < 0.001),无论托吡酯的影响如何。年轻患者和女性患者的风险更高。风险程度与头痛门诊就诊的年频率成正比(≥6次与<3次相比,aHR = 1.11;95%CI为1.04 - 1.17;p = 0.002),但有先兆和无先兆的偏头痛患者之间无差异。
我们的研究表明偏头痛与尿结石风险增加相关,与托吡酯的使用无关。门诊就诊频率较高与更大风险相关。