Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health, and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Eur J Neurol. 2023 Jun;30(6):1815-1827. doi: 10.1111/ene.15753. Epub 2023 Mar 9.
Migraine and thyroid dysfunction, particularly hypothyroidism, are common medical conditions and are known to have high heritability. Thyroid function measures, thyroid stimulating hormone (TSH) and free thyroxine (fT4), are also known to be genetically influenced. Although observational epidemiological studies report an increased co-occurrence of migraine and thyroid dysfunction, a clear and combined interpretation of the findings is currently lacking. A narrative review is provided of the epidemiological and genetic association evidence linking migraine, hypothyroidism, hyperthyroidism and thyroid hormones TSH and fT4.
An extensive literature search was conducted in the PubMed database for epidemiological, candidate gene and genome-wide association studies using the terms migraine, headache, thyroid hormones, TSH, fT4, thyroid function, hypothyroidism and hyperthyroidism.
Epidemiological studies suggest a bidirectional relationship between migraine and thyroid dysfunction. However, the nature of the relationship remains unclear, with some studies suggesting migraine increases the risk for thyroid dysfunction whilst other studies suggest the reverse. Early candidate gene studies have provided nominal evidence for MTHFR and APOE, whilst more recently genome-wide association studies have provided robust evidence for THADA and ITPK1 being associated with both migraine and thyroid dysfunction.
These genetic associations improve our understanding of the genetic relationship between migraine and thyroid dysfunction, provide an opportunity to develop biomarkers to identify migraine patients most likely to benefit from thyroid hormone therapy, and indicate that further cross-trait genetic studies have excellent potential to provide biological insight into their relationship and inform clinical interventions.
偏头痛和甲状腺功能障碍，尤其是甲状腺功能减退，是常见的医学病症，且具有较高的遗传性。甲状腺功能的测量指标，促甲状腺激素（TSH）和游离甲状腺素（fT4），也受遗传影响。尽管观察性的流行病学研究报告偏头痛和甲状腺功能障碍的同时发生频率增加，但目前缺乏对这些发现的清晰综合解释。本文对偏头痛、甲状腺功能减退、甲状腺功能亢进和甲状腺激素 TSH 和 fT4 之间的遗传关联的流行病学和遗传关联证据进行了综述。
在 PubMed 数据库中进行了广泛的文献检索，使用偏头痛、头痛、甲状腺激素、TSH、fT4、甲状腺功能、甲状腺功能减退和甲状腺功能亢进等术语，检索了流行病学、候选基因和全基因组关联研究的文献。
流行病学研究表明偏头痛和甲状腺功能障碍之间存在双向关系。然而，这种关系的性质尚不清楚，一些研究表明偏头痛增加了甲状腺功能障碍的风险，而其他研究则表明相反。早期的候选基因研究提供了 MTHFR 和 APOE 的名义证据，而最近的全基因组关联研究则为 THADA 和 ITPK1 与偏头痛和甲状腺功能障碍都相关提供了有力证据。
这些遗传关联提高了我们对偏头痛和甲状腺功能障碍之间遗传关系的理解，为开发生物标志物提供了机会，以确定最有可能从甲状腺激素治疗中获益的偏头痛患者，并表明进一步的跨疾病遗传研究具有极好的潜力，可以提供对其关系的生物学见解，并为临床干预提供信息。
