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年龄相关性黄斑变性新生血管与偏头痛的相关性。

Association of neovascular age-related macular degeneration with migraine.

机构信息

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.

School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Sci Rep. 2022 Feb 2;12(1):1792. doi: 10.1038/s41598-022-05638-5.

Abstract

Patients with early onset vascular pathology have been reported to manifest neovascular age-related macular degeneration (AMD). While the blood vessels involved in pathogenesis of migraine remains controversial, it is generally accepted that a major contributor is blood vessel pathology. This study aimed to examine the association between migraine and AMD using a nationwide population-based dataset. Retrospective claims data were collected from the Taiwan National Health Insurance Research Database. We identified 20,333 patients diagnosed with neovascular AMD (cases), and we selected 81,332 propensity score-matched controls from the remaining beneficiaries in Taiwan's National Health Insurance system. We used Chi-square tests to explore differences in the prevalence of migraine prior to the index date between cases and controls. We performed multiple logistic regressions to estimate the odds of prior migraine among neovascular AMD patients vs. controls after adjusting for age, sex, monthly income, geographic location, residential urbanization level, hyperlipidemia, diabetes, coronary heart disease, hypertension, and previous cataract surgery. A total of 5184 of sample patients (5.1%) had a migraine claim before the index date; 1215 (6.1%) among cases and 3969 (4.9%) among controls (p < 0.001), with an unadjusted OR of 1.239 (95% CI 1.1601.324, p < 0.001) for prior migraine among cases relative to controls. Furthermore, the adjusted OR was 1.201 (95% CI 1.1231.284; p < 0.001) for AMD cases relative to controls. The study offers population-based evidence that persons with migraine have 20% higher risk of subsequently being diagnosed with neovascular AMD.

摘要

据报道,有早期血管病变的患者表现出与年龄相关的新生血管性黄斑变性(AMD)。虽然偏头痛发病机制中涉及的血管仍存在争议,但普遍认为主要原因是血管病变。本研究旨在使用全国性基于人群的数据集来检查偏头痛与 AMD 之间的关联。回顾性索赔数据来自台湾全民健康保险研究数据库。我们确定了 20,333 名患有新生血管性 AMD(病例)的患者,并从台湾全民健康保险系统中其余受益人中选择了 81,332 名符合倾向评分匹配的对照。我们使用卡方检验来探索病例和对照在索引日期之前偏头痛的患病率差异。我们使用多因素逻辑回归来估计在调整年龄、性别、月收入、地理位置、居住城市化水平、高血脂、糖尿病、冠心病、高血压和先前白内障手术后,新生血管性 AMD 患者与对照相比,先前偏头痛的可能性。在样本患者中,共有 5184 名(5.1%)在索引日期前有偏头痛记录;1215 名(6.1%)在病例中,3969 名(4.9%)在对照组中(p < 0.001),病例组与对照组相比,未经调整的比值比(OR)为 1.239(95%CI 1.1601.324,p < 0.001)。此外,调整后的 OR 为 1.201(95%CI 1.1231.284;p < 0.001),即 AMD 病例相对于对照组。该研究提供了基于人群的证据,表明偏头痛患者随后被诊断为新生血管性 AMD 的风险增加 20%。

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