1 Department of Neuroscience and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
2 Norwegian Advisory Unit on Headache, St. Olavs Hospital, Trondheim, Norway.
Cephalalgia. 2019 Jul;39(8):1022-1029. doi: 10.1177/0333102418825370. Epub 2019 Mar 12.
The relationship between high sensitivity C-reactive protein and migraine is unclear. The aim of this cross-sectional population-based study was to investigate the association between high sensitivity C-reactive protein and types of headache, and to evaluate the impact of insomnia on this association.
A total of 20,486 (63%) out of 32,591 invited, aged ≥40 years or older, participated in the seventh wave of the Tromsø study conducted in 2015-2016 and had valid information on headache, insomnia and high sensitivity C-reactive protein. The influence of insomnia on the association between questionnaire-based diagnoses of headache and elevated high sensitivity C-reactive protein defined as >3.0 mg/L was assessed using multiple logistic regression, estimating prevalence odds ratio with 95% confidence intervals.
A total of 6290 participants (30.7%) suffered from headache during the last year. Among these, 1736 (8.5%) fulfilled the criteria of migraine, 991 (4.8%) had migraine with aura, 746 (3.6%) migraine without aura (3.8%), and 4554 (22.2%) had non-migrainous headache. In the final multi-adjusted analysis, elevated high sensitivity C-reactive protein was associated with headache (odds ratio 1.10, 95% confidence interval 1.01-1.20), migraine (odds ratio 1.17, 95% confidence interval 1.01-1.35), and migraine with aura (odds ratio 1.23, 95% confidence interval 1.01-1.53). No association was found between elevated high sensitivity C-reactive protein and migraine without aura or non-migrainous headache. The association between high sensitivity C-reactive protein and migraine was strongly dependent on insomnia status. Among individuals with insomnia, elevated high sensitivity C-reactive protein was associated with migraine (odds ratio 1.49, 95% confidence interval 1.02-2.17), and migraine with aura (odds ratio 1.59, 95% confidence interval 1.03-2.45), whereas no such relationship was found among those without insomnia.
In this cross-sectional study, participants with migraine, in particular migraine with aura, were more likely to have elevated high sensitivity C-reactive protein, evident only among those with insomnia.
高敏 C 反应蛋白与偏头痛之间的关系尚不清楚。本横断面人群研究的目的是探讨高敏 C 反应蛋白与头痛类型之间的关系，并评估失眠对这种关系的影响。
共有 20486 名（63%）受邀的年龄≥40 岁的参与者参加了 2015-2016 年进行的第七轮特罗姆瑟研究，并且有有效的头痛、失眠和高敏 C 反应蛋白信息。使用多因素逻辑回归评估失眠对基于问卷的头痛诊断与升高的高敏 C 反应蛋白（定义为>3.0mg/L）之间关联的影响，使用 95%置信区间估计患病率比值比。
共有 6290 名参与者（30.7%）在过去一年中患有头痛。其中，1736 名（8.5%）符合偏头痛标准，991 名（4.8%）有偏头痛伴先兆，746 名（3.6%）有偏头痛无先兆（3.8%），4554 名（22.2%）有非偏头痛性头痛。在最终的多因素调整分析中，高敏 C 反应蛋白升高与头痛（比值比 1.10，95%置信区间 1.01-1.20）、偏头痛（比值比 1.17，95%置信区间 1.01-1.35）和偏头痛伴先兆（比值比 1.23，95%置信区间 1.01-1.53）相关。高敏 C 反应蛋白与偏头痛无先兆或非偏头痛性头痛之间无关联。高敏 C 反应蛋白与偏头痛之间的关系强烈依赖于失眠状态。在有失眠的个体中，高敏 C 反应蛋白与偏头痛（比值比 1.49，95%置信区间 1.02-2.17）和偏头痛伴先兆（比值比 1.59，95%置信区间 1.03-2.45）相关，而在无失眠的个体中则无这种关系。
在这项横断面研究中，偏头痛患者，尤其是偏头痛伴先兆患者，更有可能出现高敏 C 反应蛋白升高，只有在失眠患者中才明显。
