Wu Jielong, Yuan Xiaodong, Zhao Jiedong, Wu Yeting, Chen Dan, Ma Lingshan, Jing Chuya, Zheng Liangcheng, An Xingkai, Lin Qing, Wang Zhanxiang, Ma Qilin, Fang Jie
Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 361003 Xiamen, Fujian, China.
National Institute for Data Science in Health and Medicine, Xiamen University, 361102 Xiamen, Fujian, China.
J Oral Facial Pain Headache. 2025 Mar;39(1):165-175. doi: 10.22514/jofph.2025.017. Epub 2025 Mar 12.
Type 2 diabetes has been shown to reduce the risk of migraine, whereas insulin resistance (IR) is often elevated in migraineurs. The triglyceride glucose index (TyG) serves as a reliable surrogate marker of IR, which has been hypothesized to be associated with migraine pathophysiology. This study aimed to examine the relationship between TyG index scores and incidence as well as the severity of migraines through both cohort and cross-sectional analyses.
Using data from the China Health and Retirement Longitudinal Study (CHARLS), we evaluated migraine incidence between 2015 and 2020. TyG index values were calculated using the following formula: ln[fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The impact of TyG index scores on the incidence of migraines was assessed using a multivariate-adjusted Cox regression model. The cross-sectional study included 161 patients with migraines in Xiamen, China. The relationship between TyG index scores and different migraine characteristics was examined using multivariable and ordered logistic regression models with further subgroup analysis by migraine course.
Among the cohort participants, 1001 new migraine cases were identified during follow-up, with no significant relationship found between TyG index scores and migraine incidence (hazard ratio = 1.024 (0.916, 1.145), = 0.677 > 0.05). The cross-sectional study showed that migraine-related disability was significantly lower among patients in the second, third and fourth quartiles of TyG index scores compared to the first quartile (odds ratio = 0.402 (0.163, 0.973), 0.322 (0.128, 0.789) and 0.301 (0.119, 0.736), respectively; = 0.009). A similar trend was observed in patients with migraine history of less than ten years.
Integrating the results of both cohort and cross-sectional studies, this study suggests that IR may play a protective role in the early stages of migraine. Further research into the relevant underlying mechanisms could aid in identifying new therapeutic targets for migraine management.
2型糖尿病已被证明可降低偏头痛风险，而偏头痛患者的胰岛素抵抗（IR）通常会升高。甘油三酯葡萄糖指数（TyG）是IR的可靠替代指标，据推测其与偏头痛的病理生理学有关。本研究旨在通过队列研究和横断面分析，探讨TyG指数评分与偏头痛发病率及严重程度之间的关系。
利用中国健康与养老追踪调查（CHARLS）的数据，我们评估了2015年至2020年期间的偏头痛发病率。TyG指数值采用以下公式计算：ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。使用多变量调整的Cox回归模型评估TyG指数评分对偏头痛发病率的影响。横断面研究纳入了中国厦门的161例偏头痛患者。使用多变量和有序逻辑回归模型研究TyG指数评分与不同偏头痛特征之间的关系，并按偏头痛病程进行进一步亚组分析。
在队列参与者中，随访期间共发现1001例新发偏头痛病例，未发现TyG指数评分与偏头痛发病率之间存在显著关系（风险比 = 1.024（0.916，1.145），P = 0.677 > 0.05）。横断面研究表明，与第一四分位数相比，TyG指数评分处于第二、第三和第四四分位数的患者中，与偏头痛相关的残疾显著更低（优势比分别为0.402（0.163，0.973）、0.322（0.128，0.789）和0.301（0.119，0.736）；P = 0.009）。在偏头痛病史少于十年的患者中也观察到了类似趋势。
综合队列研究和横断面研究的结果，本研究表明IR可能在偏头痛的早期阶段发挥保护作用。对相关潜在机制的进一步研究可能有助于确定偏头痛治疗的新靶点。
