Haro Marina, Gárate Gabriel, Hernández José Luis, Olmos José Manuel, Muñoz María, González-Quintanilla Vicente, Pascual Julio
Service of Internal Medicine, University Hospital Marqués de Valdecilla, Universidad de Cantabria and Valdecilla Research Institute (IDIVAL), Santander, Spain.
Service of Neurology, University Hospital Marqués de Valdecilla, Universidad de Cantabria and Valdecilla Research Institute (IDIVAL), Santander, Spain.
Headache. 2025 May;65(5):863-870. doi: 10.1111/head.14901. Epub 2025 Jan 13.
Serum 25-hydroxyvitamin D (25[OH]D) concentrations have been shown to be low in patients with migraine, but results are controversial regarding the current role of vitamin D in migraine severity. Using a case-control design, we aimed to evaluate serum 25(OH)D levels in a group of females with high-frequency episodic migraine/chronic migraine (HF/CM) and analyze its association with headache frequency and serum calcitonin gene-related peptide (CGRP) levels.
Serum 25(OH)D levels were measured in 97 females with HF/CM (age 48.9 ± 9.4 years) and 146 healthy females (47.4 ± 8.1 years). Participants taking vitamin D supplements were excluded. Serum concentrations of 25(OH)D were determined by electrochemiluminescence (Roche, Germany), and CGRP levels were measured by enzyme-linked immunosorbent assay (Abbexa, UK).
Mean 25(OH)D levels in females with HF/CM (median [interquartile range] 19.0 [13.0-24.5] ng/mL) were below the values considered for insufficiency or deficiency and significantly lower than controls (25.0 [19-29.8] ng/mL; p < 0.0001). Fifty (51.5%) patients with HF/CM had levels below 20 ng/mL. There was no significant association between vitamin D levels and monthly headache days (Spearman's rank correlation coefficient [rho]: -0.086; p = 0.404) or with serum α (rho: 0.114; p = 0.267) and β-CGRP (rho: 0.113; p = 0.276) levels. Serum 25(OH)D levels in females with HF/CM with a minimum daily sunlight exposure were significantly higher than those without (23.0 [15.0-26.0] ng/mL vs. 14.0 [10.0-20.0] ng/mL; p < 0.001). Females with HF/CM who performed exercise had higher, albeit not significant, plasma 25(OH)D levels than those who did not (21.0 [15.5-28.0] ng/mL vs. 16.5 [12.0-24.0] ng/mL; p = 0.059).
Serum concentrations of 25(OH)D were low in many patients with HF/CM. Because there was no correlation with migraine frequency or serum CGRP levels, this deficiency seems to be a direct consequence of the migraine impact. Our data do not support either a relationship of 25(OH)D levels with migraine severity or the use of vitamin D supplements as a specific migraine treatment, although further studies are needed.
已有研究表明偏头痛患者血清25-羟维生素D（25[OH]D）浓度较低，但关于维生素D在偏头痛严重程度方面的当前作用，研究结果存在争议。我们采用病例对照设计，旨在评估一组高频发作性偏头痛/慢性偏头痛（HF/CM）女性的血清25(OH)D水平，并分析其与头痛频率及血清降钙素基因相关肽（CGRP）水平的关联。
测定了97例HF/CM女性（年龄48.9±9.4岁）和146例健康女性（47.4±8.1岁）的血清25(OH)D水平。排除服用维生素D补充剂的参与者。采用电化学发光法（德国罗氏公司）测定血清25(OH)D浓度，采用酶联免疫吸附测定法（英国Abbexa公司）测定CGRP水平。
HF/CM女性的平均25(OH)D水平（中位数[四分位间距]为19.0[13.0 - 24.5] ng/mL）低于被认为不足或缺乏的值，且显著低于对照组（25.0[19 - 29.8] ng/mL；p < 0.0001）。50例（51.5%）HF/CM患者的水平低于20 ng/mL。维生素D水平与每月头痛天数（斯皮尔曼等级相关系数[rho]：-0.086；p = 0.404）或血清α（rho：0.114；p = 0.267）及β-CGRP（rho：0.113；p = 0.276）水平之间无显著关联。每日最少有阳光照射的HF/CM女性的血清25(OH)D水平显著高于无阳光照射者（23.0[15.0 - 26.0] ng/mL对14.0[10.0 - 20.0] ng/mL；p < 0.001）。进行运动的HF/CM女性的血浆25(OH)D水平虽无显著升高，但高于未运动者（21.0[15.5 - 28.0] ng/mL对16.5[12.0 - 24.0] ng/mL；p = 0.059）。
许多HF/CM患者的血清25(OH)D浓度较低。由于其与偏头痛频率或血清CGRP水平无相关性，这种缺乏似乎是偏头痛影响的直接后果。我们的数据不支持25(OH)D水平与偏头痛严重程度之间的关系，也不支持使用维生素D补充剂作为偏头痛的特异性治疗方法，尽管还需要进一步研究。
