Zhang Ditte Georgina, Amin Faisal Mohammad, Guo Song, Vestergaard Mark B, Hougaard Anders, Ashina Messoud
Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark.
Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark.
Headache. 2020 Apr;60(4):655-664. doi: 10.1111/head.13760. Epub 2020 Feb 7.
To investigate plasma glucose changes during the ictal state of migraine compared to the interictal state.
Previous studies suggest abnormal glucose metabolism in migraine patients during and outside of attacks. It is not known if plasma glucose levels change during spontaneous migraine attacks.
Plasma glucose levels were measured during and outside of spontaneous migraine attacks with and without aura. Plasma glucose values were corrected for diurnal variation of plasma glucose by subtracting the difference between the moving average (intervals of 2 hours) and overall mean from the plasma glucose values.
This was a sub-study of a larger study conducted at Rigshospitalet Glostrup in the Capital Region of Denmark. Thirty-one patients (24 F, 7 M, 13 with aura, 18 without aura) were included in the study. Mean time from attack onset to blood sampling was 7.6 hours. Mean pain at the time of investigation was 6 on a 0-10 verbal rating scale. Plasma glucose was higher ictally compared to the interictal phase (interictal mean: 88.63 mg/dL, SD 11.70 mg/dL; ictal mean: 98.83 mg/dL, SD 13.16 mg/dL, difference 10.20 mg/dL, 95% CI = [4.30; 16.10]), P = .0014). The ictal increase was highest in patients investigated early during attacks and decreased linearly with time from onset of migraine (-1.57 mg/dL/hour from onset of attack, P = .020). The attack-related increase in blood glucose was not affected by pain intensity or presence of aura symptoms.
We demonstrated higher plasma glucose values during spontaneous migraine attacks, independent of the presence of aura symptoms and not related to pain intensity, peaking in the early phase of attacks. Additional studies are necessary to confirm our findings and explore the possible underlying mechanisms.
与发作间期相比，研究偏头痛发作期的血糖变化。
先前的研究表明偏头痛患者在发作期间及发作之外存在葡萄糖代谢异常。目前尚不清楚在自发性偏头痛发作期间血糖水平是否会发生变化。
在有先兆和无先兆的自发性偏头痛发作期间及发作之外测量血糖水平。通过从血糖值中减去移动平均值（2小时间隔）与总体平均值之间的差值，对血糖值进行昼夜变化校正。
这是在丹麦首都地区格洛斯楚普市里格霍斯皮塔尔进行的一项更大规模研究的子研究。31名患者（24名女性，7名男性，13名有先兆，18名无先兆）纳入研究。从发作开始到采血的平均时间为7.6小时。调查时的平均疼痛程度在0至10的语言评分量表上为6分。与发作间期相比，发作期的血糖更高（发作间期平均值：88.63mg/dL，标准差11.70mg/dL；发作期平均值：98.83mg/dL，标准差13.16mg/dL，差值10.20mg/dL，95%置信区间=[4.30；16.10]），P=0.0014）。发作期的升高在发作早期接受调查的患者中最高，并随偏头痛发作时间呈线性下降（发作开始后每小时下降1.57mg/dL，P=0.020）。与发作相关的血糖升高不受疼痛强度或先兆症状的影响。
我们证明了在自发性偏头痛发作期间血糖值更高，与先兆症状的存在无关，也与疼痛强度无关，在发作早期达到峰值。需要进一步的研究来证实我们的发现并探索可能的潜在机制。
