血清维生素 B12 和甲基丙二酸水平在偏头痛患者中的变化：一项病例对照研究。

Serum Vitamin B12 and Methylmalonic Acid Status in Migraineurs: A Case-Control Study.

机构信息

Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Headache. 2019 Oct;59(9):1492-1503. doi: 10.1111/head.13618. Epub 2019 Aug 31.

DOI:10.1111/head.13618

PMID:31471907

Abstract

BACKGROUND

Although the exact pathophysiological mechanistic pathways that result in the initiation of migraine attacks remain unclear, there are some proposed mechanisms including neurogenic inflammation, trigeminovascular system activation, vascular dysfunction, and augmented release of nitric oxide (NO) and homocysteine (Hcy). Vitamin B12 is thought to be involved in important pathways that seem to be related to the pathogenesis of migraine including scavenging against NO and prevention of hyperhomocysteinemia. Therefore, the aim of the current study was to evaluate the serum vitamin B12 and methylmalonic acid (MMA) status in a group of migraine patients compared to healthy controls.

METHODS

After the recruitment of cases and controls, demographic data and migraine characteristics (including the number of headache days, severity of headaches, and duration of each attack in hours) were recorded. Serum vitamin B12 and MMA levels were measured using the enzyme-linked immunosorbent assay technique.

RESULTS

Seventy migraine patients and 70 healthy subjects were enrolled in this case control study. The serum levels of B12 were found to be significantly lower in migraine patients than in healthy subjects (512 ± 300 vs 667 ± 351 pg/mL, P = .007); whereas migraineurs had higher levels of MMA than controls (1.39 [0.59,4.01] vs 1.01 [0.49,1.45] µg/dL, P = .027). In the fully adjusted multiple regression model, those in the highest vs the lowest serum B12 quartile had 80% decrease in the odds of having migraine ([OR = 0.20, 95% CI = 0.05-0.73], [P for trend = .008]); while, patients in the highest quartile of MMA had more than 5 times increased risk of having migraine ([OR = 5.44, 95% CI = 1.49-19.87] [P for trend = .002]). There was no association between serum B12 and MMA levels and headache characteristics.

CONCLUSION

Taken together, these findings suggest that participants with lower vitamin B12 and higher MMA levels that considered as lower functional activity of B12 had higher odds of migraine.

摘要

背景

尽管导致偏头痛发作的确切病理生理机制尚不清楚，但有一些被提出的机制包括神经源性炎症、三叉血管系统激活、血管功能障碍以及一氧化氮（NO）和同型半胱氨酸（Hcy）的释放增加。维生素 B12 被认为参与了与偏头痛发病机制相关的重要途径，包括清除 NO 和预防高同型半胱氨酸血症。因此，本研究旨在评估一组偏头痛患者与健康对照组相比的血清维生素 B12 和甲基丙二酸（MMA）水平。

方法

在招募病例和对照组后，记录人口统计学数据和偏头痛特征（包括头痛天数、头痛严重程度和每次发作持续时间）。使用酶联免疫吸附测定技术测量血清维生素 B12 和 MMA 水平。

结果

本病例对照研究共纳入 70 例偏头痛患者和 70 例健康受试者。与健康对照组相比，偏头痛患者的血清 B12 水平明显降低（512±300 vs 667±351 pg/mL，P=0.007）；而偏头痛患者的 MMA 水平高于对照组（1.39[0.59，4.01] vs 1.01[0.49，1.45] µg/dL，P=0.027）。在完全调整的多元回归模型中，血清 B12 水平最高四分位与最低四分位相比，偏头痛发生的几率降低了 80%（[OR=0.20，95%CI=0.05-0.73]，[趋势 P=0.008]）；而 MMA 水平最高四分位的患者偏头痛发生的风险增加了 5 倍以上（[OR=5.44，95%CI=1.49-19.87]，[趋势 P=0.002]）。血清 B12 和 MMA 水平与头痛特征之间没有关联。