Kim Byung-Su, Lee Mi Ji, Kim Byung-Kun, Sohn Jong-Hee, Song Tae-Jin, Chu Min Kyung, Kim Soo-Kyoung, Park Jeong Wook, Moon Heui-Soo, Chung Pil-Wook, Cho Soo-Jin
Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Headache Pain. 2025 Jun 20;26(1):144. doi: 10.1186/s10194-025-02061-9.
Cluster headache (CH) is the most painful headache disorder. Despite a large body of evidence on obesity's negative influence on migraine, its impact on cluster headache disease activity remains unexplored. We aimed to determine whether body mass index (BMI) and obesity are associated with lifetime bout occurrence and annual bout frequency in patients with episodic cluster headache (ECH).
The Korean Cluster Headache Registry (KCHR) is a prospective, multicenter registry of consecutive patients with CH over 4 years. This cross-sectional study included 316 eligible patients with ECH, with ≥ 2 years of duration of CH disease and ≥ 2 times of lifetime bout occurrence. Obesity was determined using the Asia-Pacific classification (obese: BMI ≥ 25.0 kg/m). Bout frequency was defined as an average annual number of bout occurrence: number of lifetime bout occurrence divided by total duration of CH disease. The main outcomes included odds ratios (ORs) of BMI and obesity for quartiles of lifetime bout occurrence and annual bout frequency by performing ordinal logistic regression analysis.
The mean (SD) age of the patients was 37 (9.7); 50 (15.8%) were female. The mean (SD) BMI was 23.9 (3.2) kg/m; 105 (33.2%) were obese. The median (interquartile range) duration of CH disease was 10 (6-16) years; lifetime bout occurrence was 7 (4-12); and annual bout frequency was 0.88 (0.5-1.10). In multivariable adjusted models, OR of BMI (per 1 kg/m) and the obese group for lifetime bout occurrence were 0.89; 95% CI, 0.84-0.95 and 0.40; 95% CI, 0.23-0.68. Age, BMI, and seasonal propensity were associated factors for annual bout frequency. After multivariable adjustment, BMI and obesity were inversely associated with annual bout frequency (BMI per 1 kg/m OR: 0.92; 95% CI: 0.86-0.98 and obese OR: 0.52; 95% CI: 0.32-0.86).
BMI and obesity were inversely associated with lifetime bout occurrence and annual bout frequency in ECH, suggesting that neurobiological aspects of obesity may suppress cluster bout periodicity.
丛集性头痛（CH）是最疼痛的头痛疾病。尽管有大量证据表明肥胖对偏头痛有负面影响，但其对丛集性头痛疾病活动的影响仍未得到探索。我们旨在确定体重指数（BMI）和肥胖是否与发作性丛集性头痛（ECH）患者的终生发作次数和每年发作频率相关。
韩国丛集性头痛登记处（KCHR）是一个对连续4年的CH患者进行前瞻性、多中心登记的机构。这项横断面研究纳入了316例符合条件的ECH患者，其CH病程≥2年且终生发作次数≥2次。肥胖采用亚太地区分类法确定（肥胖：BMI≥25.0kg/m）。发作频率定义为每年发作次数的平均值：终生发作次数除以CH疾病的总病程。主要结局包括通过进行有序逻辑回归分析得出的BMI和肥胖对于终生发作次数四分位数和每年发作频率的比值比（OR）。
患者的平均（标准差）年龄为37（9.7）岁；50例（15.8%）为女性。平均（标准差）BMI为23.9（3.2）kg/m；105例（33.2%）为肥胖。CH疾病的中位（四分位间距）病程为10（6 - 16）年；终生发作次数为7（4 - 12）次；每年发作频率为0.88（0.5 - 1.10）。在多变量调整模型中，BMI（每1kg/m）和肥胖组对于终生发作次数的OR分别为0.89；95%置信区间为0.84 - 0.95和0.40；95%置信区间为0.23 - 0.68。年龄、BMI和季节性倾向是每年发作频率的相关因素。经过多变量调整后，BMI和肥胖与每年发作频率呈负相关（BMI每1kg/m的OR：0.92；95%置信区间：0.86 - 0.98，肥胖的OR：0.52；95%置信区间：0.32 - 0.86）。
BMI和肥胖与ECH患者的终生发作次数和每年发作频率呈负相关，提示肥胖的神经生物学方面可能抑制丛集性发作的周期性。
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