BOSTON—Obesity joins the list of risk factors for episodic migraine, along with age, sex and race, according to a new study presented at the International Headache Congress 2013 meeting.
B. Lee Peterlin, DO, Associate Professor of Neurology at Johns Hopkins University School of Medicine, and colleagues conducted a cross-sectional study of 3,862 black and white adult participants interviewed in the National Comorbidity Survey Replicated. Episodic migraine diagnostic criteria were based on the International Classification of Headache Disorders. Body mass index (BMI) was classified as underweight, (less than 18.5 kg/m2), normal (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), and obese (greater than 30 kg/m2). Odds ratios (OR) and 95% confidence intervals (CI) for migraine were estimated using logistic regression and adjusted for demographics and health characteristics. Models were also stratified by age (younger than or older than 50), race (white or black), and sex (male or female).
The mean BMI was greater in those with episodic migraine (27.8), compared with controls (27.1). The unadjusted prevalence estimates of obesity were 32.2% among those with episodic migraine and 26.0% among controls. In all participants, the adjusted odds of episodic migraine were 81% greater in obese as compared to normal weighted individuals (OR 1.81). In addition, stratified analyses demonstrated that the odds of episodic migraine were greater in obese as compared to normal weighted individuals who were: younger than 50 (OR 1.86), white (OR 2.06), or female (OR 1.95), and were not increased in those older than 50 (OR 1.15) or men (OR 1.43). Due to the small number of black participants with episodic migraine, no conclusion could be drawn regarding the odds of episodic migraine in obese black participants alone. Similar findings were demonstrated in lower frequency episodic migraine subgroups.
“There has been controversy about whether obesity is associated with an increased risk of migraine in general or if this risk was limited to just chronic or high frequency migraine sufferers,” said Dr. Peterlin. “This study demonstrates that the risk of migraine in those with obesity extends to episodic migraineurs, even those with low frequencies. Specifically, in those with obesity, the odds of episodic migraine in general were increased by 81%, while the odds of lower frequency episodic migraine increased by 83% to 89%. Further, we found that the risk of episodic migraine in those with obesity was greatest in those under 50 years of age, white individuals, and women.”