Graif Yael, Shohat Tamy, Machluf Yossy, Farkash Rivka, Chaiter Yoram
Allergy and Immunology Clinic, Pulmonary Institute, Rabin Medical Center, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel.
Clin Respir J. 2018 Oct;12(10):2491-2496. doi: 10.1111/crj.12939. Epub 2018 Oct 4.
Epidemiological studies have reported an association between asthma and migraine, mainly in adults.
To examine the association between specialist-diagnosed asthma and migraine among adolescents.
The electronic database of a recruitment center was retrospectively searched for all 17-year-old draftees during the years 1987-2010. Diagnoses of asthma and migraine were made by certified specialists. The prevalence of migraine was compared among draftees with and without asthma. Covariate data on socio-demographics and associated medical conditions were recorded.
A total of 113 671 adolescents were available for analysis. Asthma was diagnosed among 4.0% and migraine among 1.9%. Migraine was significantly more prevalent among adolescents with asthma [174 of the 4581 subjects (3.8%)] compared to those without asthma [1946 of the 109 090 (1.8%)] [OR = 2.17 (95% CI 1.86-2.55; P < 0.001)]. Rates of migraine among subjects with and without allergic rhinitis were 6.3% and 1.7%, respectively [OR = 4.04 (95% CI 3.58-4.56; P < 0.001)]. On multivariate analysis, there was a significant association between migraine and both asthma [OR = 1.42 (95% CI 1.19-1.68)] and allergic rhinitis [OR = 3.18 (95% CI 2.80-3.63)]. Other factors significantly associated with migraine were female gender, urban area of residence, recent immigration to Israel, having three or fewer siblings, and abnormal body mass index.
Clinicians should be aware that asthma and allergic rhinitis are potential risk factors for migraine in adolescents. A combined finding of these conditions and recurrent headache is highly suggestive of migraine and warrants a different diagnosis and treatment approach from sinusitis.
流行病学研究报告了哮喘与偏头痛之间的关联，主要发生在成年人中。
研究青少年中专科医生诊断的哮喘与偏头痛之间的关联。
对一家招募中心的电子数据库进行回顾性检索，以查找1987年至2010年间所有17岁的应征入伍者。哮喘和偏头痛的诊断由认证专家做出。比较有哮喘和无哮喘应征入伍者的偏头痛患病率。记录社会人口统计学和相关医疗状况的协变量数据。
共有113671名青少年可供分析。4.0%的青少年被诊断为哮喘，1.9%的青少年被诊断为偏头痛。与无哮喘的青少年[109090名中的1946名（1.8%）]相比，哮喘青少年中偏头痛的患病率显著更高[4581名受试者中的174名（3.8%）][比值比=2.17（95%可信区间1.86-2.55；P<0.001）]。有和无过敏性鼻炎的受试者中偏头痛的发生率分别为6.3%和1.7%[比值比=4.04（95%可信区间3.58-4.56；P<0.001）]。多变量分析显示，偏头痛与哮喘[比值比=1.42（95%可信区间1.19-1.68）]和过敏性鼻炎[比值比=3.18（95%可信区间2.80-3.63）]均存在显著关联。与偏头痛显著相关的其他因素包括女性、居住在城市地区、近期移民到以色列、兄弟姐妹数为三个或更少以及体重指数异常。
临床医生应意识到哮喘和过敏性鼻炎是青少年偏头痛的潜在危险因素。这些情况与复发性头痛的综合表现高度提示偏头痛，需要与鼻窦炎进行不同的诊断和治疗。
