Alebna Pamela, Maleki Nasim
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Front Neurol. 2021 Apr 22;12:649423. doi: 10.3389/fneur.2021.649423. eCollection 2021.
There is very limited data on women with migraine disease as they age and transition to menopause. Despite evidence for the increased burden of the disease during this transition, there is no data on the association between migraine and allostatic load as a marker of cumulative biological risk. We aimed to determine whether women with migraine suffer from higher levels of allostatic load during perimenopausal transition. A total of 2,105 perimenopausal women from the first wave of the Study of Women's Health Across the Nation (SWAN) were included in this study. Allostatic Load (AL) score was estimated for each participant from the measurements of: systolic and diastolic blood pressure, C-reactive protein level, high-density lipoprotein cholesterol level, total cholesterol level, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone levels. Of the 2,105 participants included in the study, there were 369 migraineurs and 1,730 controls. Migraineurs had 63% higher odds of increased load score (odds ratio 1.63; 95% confidence interval, 1.17-2.29). Compared to controls, migraineurs were more likely to experience sleep problems in the univariate analysis, however despite the high burden of sleep problems, there were no significant associations between allostatic load and sleep disturbances in perimenopausal women with migraine after controlling for other factors. This is the first study to systematically and quantitatively examine allostatic load in migraine patients. The findings establish that migraineurs are more likely to experience higher allostatic load than their non-migraine counterparts during perimenopausal transition. The findings encourage new lines of investigation for lowering the burden of the disease through interventions that modify the levels of allostatic load biomarkers examined in this study.
关于患有偏头痛疾病的女性随着年龄增长并进入更年期的数据非常有限。尽管有证据表明在此过渡期间该疾病的负担会增加，但关于偏头痛与作为累积生物学风险标志物的应激负荷之间的关联却没有相关数据。我们旨在确定处于围绝经期过渡阶段的偏头痛女性是否承受更高水平的应激负荷。本研究纳入了来自全国女性健康研究（SWAN）第一波的总共2105名围绝经期女性。通过测量收缩压和舒张压、C反应蛋白水平、高密度脂蛋白胆固醇水平、总胆固醇水平、腰臀比、空腹血清葡萄糖、甘油三酯以及脱氢表雄酮水平，为每位参与者估算应激负荷（AL）得分。在纳入研究的2105名参与者中，有369名偏头痛患者和1730名对照者。偏头痛患者的负荷得分增加的几率高出63%（优势比1.63；95%置信区间，1.17 - 2.29）。在单变量分析中，与对照者相比，偏头痛患者更有可能出现睡眠问题，然而，尽管睡眠问题负担较重，但在控制其他因素后，患有偏头痛的围绝经期女性的应激负荷与睡眠障碍之间没有显著关联。这是第一项系统且定量地研究偏头痛患者应激负荷的研究。研究结果表明，在围绝经期过渡阶段，偏头痛患者比非偏头痛患者更有可能承受更高的应激负荷。这些发现鼓励通过干预措施来降低疾病负担，从而开展新的研究方向，这些干预措施可以改变本研究中所检测的应激负荷生物标志物的水平。
