Cavestro Cinzia, Bedogni Giorgio, Molinari Filippo, Mandrino Silvia, Rota Eugenia, Frigeri Maria Cristina
1 Headache Center , San Lazzaro Hospital, Azienda Sanitaria Locale CN2, Alba, CN, Italy .
2 Clinical Epidemiology Unit, Liver Research Center , Basovizza, TS, Italy .
J Med Food. 2018 Mar;21(3):269-273. doi: 10.1089/jmf.2017.0068. Epub 2017 Oct 4.
Alpha-lipoic acid (ALA) is known to lower insulin resistance (IR), which is common among migraineurs. To assess the effect of ALA on headache in migraineurs with IR, we performed an exploratory study on a cohort of patients with migraine, followed at our Headache Center. The 32 patients took ALA 400 mg b.i.d. for 6 months in addition to their on-going treatment. The percentage of patients with a reduction of at least 50% of the attacks was 0.53 (confidence interval [95% CI] 0.36-0.70) at 2 months, 0.56 (0.39-0.73) at 4 months, and 0.69 (0.53-0.85) at 6 months. The incidence rate ratio of attacks at 6 months versus baseline was 0.48 (0.43-0.53, P < .001), corresponding to a mean (95% CI) number of attacks of 5 (4-6) versus 11 (10-12). The number of days of treatment in the previous month was 7.7 (6.8-8.7) at baseline, 5.4 (4.6-6.2) at 2 months, 5.3 (4.5-6.1) at 4 months, and 4.3 (3.6-5.0) at 6 months. Baseline and 120-min glucose and insulin and quantitative insulin sensitivity check index (QUICKI) and the Stumvoll index did not change at 6 months versus baseline. This exploratory study shows that the administration of ALA may be associated with a reduction in the number of attacks and the days of treatment in migraineurs with IR. A randomized controlled trial is needed to test this possibility.
已知α-硫辛酸（ALA）可降低胰岛素抵抗（IR），而胰岛素抵抗在偏头痛患者中很常见。为评估ALA对伴有IR的偏头痛患者头痛的影响，我们对在我们头痛中心随访的一组偏头痛患者进行了一项探索性研究。32名患者在持续治疗的基础上，每天两次服用400毫克ALA，持续6个月。发作次数减少至少50%的患者百分比在2个月时为0.53（置信区间[95%CI]0.36 - 0.70），4个月时为0.56（0.39 - 0.73），6个月时为0.69（0.53 - 0.85）。6个月时与基线相比发作的发病率比为0.48（0.43 - 0.53，P < 0.001），相当于发作的平均（95%CI）次数从11（10 - 12）次降至5（4 - 6）次。前一个月的治疗天数在基线时为7.7（6.8 - 8.7）天，2个月时为5.4（4.6 - 6.2）天，4个月时为5.3（4.5 - 6.1）天，6个月时为4.3（3.6 - 5.0）天。6个月时与基线相比，基线及120分钟时的血糖、胰岛素以及定量胰岛素敏感性检查指数（QUICKI）和斯图姆沃尔指数均未改变。这项探索性研究表明，给予ALA可能与伴有IR的偏头痛患者发作次数和治疗天数的减少有关。需要进行一项随机对照试验来验证这种可能性。
