Department of Neurology, Baskent University Faculty of Medicine, Ankara, Turkey.
Department of Emergency Medicine, Baskent University Faculty of Medicine, Ankara, Turkey.
Neurol Sci. 2019 Apr;40(4):703-711. doi: 10.1007/s10072-019-3710-5. Epub 2019 Jan 15.
Migraine is a common neurovascular disease associated with vascular risks, especially in young adult females, but the mechanism underlying these associations remains unknown. This study evaluated the relationships between plasma endothelial dysfunction biomarkers and carotid intima-media thickness (IMT) in young adult females with migraine.
This case-control study included 148 female patients (age range: 18-50 years). Migraine was diagnosed according to the International Headache Society-IIIb criteria. Endothelial dysfunction biomarkers, such as von Willebrand factor (vWF), C-reactive protein (CRP), homocysteine, total nitrate/nitrite concentration, and thiobarbituric acid-reactive substances (TBARS), were evaluated in plasma. Carotid IMT was measured by a radiologist with sonography.
The CRP, TBARS, vWF, and IMT levels were increased in the migraine compared with the control group (p < 0.001, p = 0.02, p < 0.001, and p < 0.001, respectively). After adjusting for confounders, multiple linear regression analysis revealed that systolic arterial blood pressure, CRP, vWF, TBARS, and right and left internal carotid artery (ICA) IMT were independently positively correlated with migraine (p < 0.01, p = 0.004, p = 0.023, p = 0.024, p = 0.032, and p = 0.048, respectively). Multiple logistic regression analysis revealed that right ICA IMT was independently associated with ergotamine and triptan and left ICA IMT was independently associated with ergotamine (p = 0.013, p = 0.026, and p = 0.017, respectively). In addition, significant correlations were found between LDL lipoprotein and carotid IMT in the migraine group (p < 0.05).
Carotid IMT enhancement and elevated TBARS, vWF, and CRP levels in migraine subjects during a migraine attack could be regarded as consequences of migraine attack pathophysiology. The independent associations between triptan and ergotamine consumption and enhanced carotid IMT suggest that repeated use of these vasoconstrictive antimigraine agents may have additional effects on carotid IMT.
偏头痛是一种常见的与血管风险相关的神经血管疾病，尤其是在年轻成年女性中，但这些关联的机制尚不清楚。本研究评估了偏头痛年轻成年女性血浆内皮功能障碍生物标志物与颈动脉内膜中层厚度（IMT）之间的关系。
本病例对照研究纳入了 148 名女性患者（年龄范围：18-50 岁）。偏头痛根据国际头痛协会-IIIb 标准进行诊断。评估了血浆中的内皮功能障碍生物标志物，如血管性血友病因子（vWF）、C 反应蛋白（CRP）、同型半胱氨酸、总硝酸盐/亚硝酸盐浓度和硫代巴比妥酸反应物质（TBARS）。颈动脉 IMT 由放射科医生用超声测量。
与对照组相比，偏头痛组的 CRP、TBARS、vWF 和 IMT 水平升高（p<0.001、p=0.02、p<0.001 和 p<0.001，分别）。在校正混杂因素后，多元线性回归分析显示，收缩压、CRP、vWF、TBARS 以及右侧和左侧颈内动脉（ICA）IMT 与偏头痛独立正相关（p<0.01、p=0.004、p=0.023、p=0.024、p=0.032 和 p=0.048，分别）。多元逻辑回归分析显示，右侧 ICA IMT 与麦角胺和曲坦独立相关，左侧 ICA IMT 与麦角胺独立相关（p=0.013、p=0.026 和 p=0.017，分别）。此外，在偏头痛组中还发现 LDL 脂蛋白与颈动脉 IMT 之间存在显著相关性（p<0.05）。
偏头痛发作期间偏头痛患者颈动脉 IMT 增强以及 TBARS、vWF 和 CRP 水平升高可视为偏头痛发作病理生理学的后果。曲坦和麦角胺的使用与颈动脉 IMT 增强之间的独立关联表明，这些血管收缩性抗偏头痛药物的重复使用可能对颈动脉 IMT 有额外的影响。
