前瞻性队列研究：日常酒精饮料摄入作为发作性偏头痛成人头痛潜在诱因。
Prospective cohort study of daily alcoholic beverage intake as a potential trigger of headaches among adults with episodic migraine.
机构信息
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA.
出版信息
Ann Med. 2020 Nov;52(7):386-392. doi: 10.1080/07853890.2020.1758340. Epub 2020 Apr 29.
PURPOSE
To determine whether alcohol intake is associated with occurrence of headaches on the following day.
METHODS
In this prospective cohort study, adults with episodic migraine completed electronic diaries every morning and evening for at least six weeks in March 2016-October 2017. Every day, participants reported alcohol intake, lifestyle factors, and details about each headache. We constructed within-person fixed-effect models adjusted for time-varying factors to calculate odds ratios for the association between 1,2,3,4, or 5+ servings of alcohol and headache the following day. We also calculated the adjusted risk of headache the following day for each level of intake.
RESULTS
Among 98 participants who reported 825 headaches over 4,467 days, there was a statistically significant linear association (p-trend = 0.03) between alcohol and headache the following day. Compared to no alcohol, 1-2 servings were not associated with headaches, but 5+ servings were associated with a 2.08-fold (95% confidence interval [CI] 1.16-3.73) odds of headache. The adjusted absolute risk of headaches was 20% (95%CI 19%-22%) on days following no alcohol compared with 33% (95%CI 22%-44%) on days following 5+ servings.
CONCLUSION
1-2 servings of alcoholic beverages were not associated with higher risk of headaches the following day, but 5+ servings were associated with higher risk. KEY MESSAGES 1-2 servings of alcoholic beverages were not associated with a higher risk of headaches on the following day, but higher levels of intake may be associated with higher risk. Five or more servings were associated with 2.08 times (95% confidence interval 1.16-3.73 the odds of headache on the following day. The adjusted absolute risk of headaches was 20% (95%CI 19%-22%) on days following no alcohol consumption compared with 33% (95% CI 22%-44%) on days following 5+ servings.
目的
确定饮酒是否与次日头痛的发生有关。
方法
在这项前瞻性队列研究中，患有发作性偏头痛的成年人在 2016 年 3 月至 2017 年 10 月期间至少连续 6 周每天早晚通过电子日记记录。每天，参与者报告饮酒量、生活方式因素以及每次头痛的详细信息。我们构建了个体内固定效应模型，以调整随时间变化的因素，计算 1 份、2 份、3 份、4 份或 5 份以上的酒精与次日头痛之间的关联的比值比。我们还计算了每种饮酒量水平次日发生头痛的调整后风险。
结果
在 98 名报告了 825 次头痛的参与者中，在 4467 天内，酒精与次日头痛之间存在统计学上显著的线性关联（趋势检验 p=0.03）。与不饮酒相比，1-2 份酒精与头痛无关，但 5 份以上的酒精与头痛的风险增加 2.08 倍（95%置信区间 [CI] 1.16-3.73）。不饮酒的日子里，头痛的调整后绝对风险为 20%（95%CI 19%-22%），而 5 份以上的日子里，头痛的绝对风险为 33%（95%CI 22%-44%）。
结论
1-2 份酒精饮料与次日头痛风险增加无关，但较高水平的摄入可能与更高的风险有关。
关键信息
1-2 份酒精饮料与次日头痛风险增加无关，但较高水平的摄入可能与更高的风险有关。5 份或更多份酒精与次日头痛的风险增加 2.08 倍（95%置信区间 1.16-3.73）相关。不饮酒的日子里，头痛的调整后绝对风险为 20%（95%CI 19%-22%），而 5 份以上的日子里，头痛的调整后绝对风险为 33%（95%CI 22%-44%）。
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