1 Hospital Universitário, University of São Paulo, São Paulo, Brazil.
2 Center for Clinical and Epidemiological Research, University of São Paulo, Medical School, Sao Paulo, Brazil.
Cephalalgia. 2018 Mar;38(3):528-542. doi: 10.1177/0333102417699181. Epub 2017 Mar 16.
Introduction Recent studies have explored the relationship between dyslipidemia and migraine in a cardiovascular context. Thus, we aimed to evaluate the possible association between lipids, lipoprotein subfractions and migraine according to aura symptoms in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods 1,560 women and 1,595 men, without CVD or lipid disorders requiring medication, underwent a baseline clinical assessment. Total-cholesterol and its sub-fractions (LDL, VLDL and HDL subclass cholesterol); triglycerides and triglyceride-rich lipoprotein cholesterol [TRL-C (VLDL-C VLDL-C + IDL-C)] were determined by vertical auto profile (VAP). We also calculated logarithmic LDL density ratio [LLDR = ln ((LDL-C + LDL-C)/(LDL-C + LDL-C))], T-Chol/HDL-C and triglycerides/HDL-C ratios. Odds ratios (OR) with 95% confidence intervals (CI) were obtained to evaluate the relationship between lipids tertiles and migraine for both sexes. Results Main findings revealed positive associations between migraine without aura (MO) and the highest tertiles of VLDL-C (OR, 1.61; 95%CI, 1.07-2.40) and TRL-C (OR, 1.55; 95% CI, 1.03-2.34) in women. In men, the highest tertile of VLDL-C (OR, 3.87; 95%CI, 1.23-12.19) was positively associated with MO, as well. Conclusions In middle-aged participants without CVD or lipid disorders requiring medication, the worst lipid profile was determined by the highest levels of TRL-C and their cholesterol-rich remnants in migraineurs without aura for both sexes.
简介 最近的研究探讨了血脂异常与偏头痛在心血管背景下的关系。因此,我们旨在评估脂质、脂蛋白亚组分与偏头痛之间的可能关联,依据的是巴西成年人健康纵向研究(ELSA-Brasil)中有无先兆偏头痛症状。
方法 在基线临床评估中,纳入了 1560 名女性和 1595 名无心血管疾病或血脂异常需药物治疗的男性。通过垂直自动分析(VAP)测定总胆固醇及其亚组分(LDL、VLDL 和高密度脂蛋白亚类胆固醇);甘油三酯和富含甘油三酯的脂蛋白胆固醇[TRL-C(VLDL-C+IDL-C)]。还计算了对数 LDL 密度比[LLDR=ln((LDL-C+LDL-C)/(LDL-C+LDL-C))]、T-Chol/HDL-C 和甘油三酯/HDL-C 比值。采用比值比(OR)及其 95%置信区间(CI)评估男女各脂质三分位组与偏头痛之间的关系。
结果 主要发现显示,在女性中,无先兆偏头痛(MO)与 VLDL-C(OR,1.61;95%CI,1.07-2.40)和 TRL-C(OR,1.55;95%CI,1.03-2.34)的最高三分位组之间存在正相关。在男性中,VLDL-C 的最高三分位组(OR,3.87;95%CI,1.23-12.19)与 MO 呈正相关。
结论 在无 CVD 或血脂异常需药物治疗的中年参与者中,无先兆偏头痛患者的血脂谱最差,由 TRL-C 及其富含胆固醇的残基水平最高决定,男女均如此。