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Insulin Resistance and High Sensitivity C-Reactive Protein in Migraine

Published online by Cambridge University Press:  02 December 2014

Baburhan Guldiken ,
Sibel Guldiken ,
Muzaffer Demir ,
Nilda Turgut ,
Levent Kabayel ,
Hulya Ozkan ,
Emine Ozcelik  and
Armagan Tugrul
Baburhan Guldiken*
Affiliation:
Department of Neurology, Medical Faculty of Trakya University, Turkey
Sibel Guldiken
Affiliation:
Department of Endocrinology, Medical Faculty of Trakya University, Edirne, Turkey
Muzaffer Demir
Affiliation:
Department of Hematology, Medical Faculty of Trakya University, Turkey
Nilda Turgut
Affiliation:
Department of Neurology, Medical Faculty of Trakya University, Turkey
Levent Kabayel
Affiliation:
Department of Neurology, Social Security Hospital, Edirne, Turkey
Hulya Ozkan
Affiliation:
Department of Neurology, Social Security Hospital, Edirne, Turkey
Emine Ozcelik
Affiliation:
Department of Biochemistry, Social Security Hospital, Edirne, Turkey
Armagan Tugrul
Affiliation:
Department of Endocrinology, Medical Faculty of Trakya University, Edirne, Turkey
*
Demirkapı mevki Kırkareli Yolu üzeri, Akasya sitesi no 4, 22030, Edirne, Turkey.
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Abstract

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Background:

A relationship between migraine and vascular disorders such as hypertension, stroke, and coronary ischemia has been recently reported. Insulin resistance and endothelial dysfunction, which commonly underlies these disorders, have not been widely investigated in migraine patients. In this study, we aimed to investigate the existence of insulin resistance and endothelial dysfunction, and their relationship to vascular risk factors in patients with migraine.

Methods:

We evaluated insulin resistance and high-sensitivity C-reactive protein (hs-CRP), a marker of endothelial dysfunction, in 60 migraine patients and 25 healthy control subjects. Multiple analysis of covariance test was used to adjust for known confounding factors that can influence insulin metabolism and endothelial function, such as obesity, blood pressure, and lipid parameters.

Results:

Insulin resistance, as measured homeostasis model assessment (HOMA)-R levels, was significantly higher in the migraine group (p<0.001). After adjustment for confounding variables, the relationship between migraine and the HOMA-R levels remained significant (p<0.001). The hs-CRP levels did not differ between the migraine and control groups.

Conclusions:

Our data show that insulin resistance is present in migraine patients. Endothelial dysfunction is not found during the headache-free period. Further studies are needed to explain the role of insulin resistance in migraine pathogenesis.

Résumé:

RÉSUMÉ:Contexte:

Selon la littérature récente, il existerait une relation entre la migraine et certains troubles vasculaires comme l’hypertension, l’accident vasculaire cérébral et l’ischémie coronarienne. La résistance à l’insuline et la dysfonction endothéliale, qui sont souvent des pathologies sous–jacentes à ces troubles vasculaires, ont été peu évaluées chez les patients migraineux. Nous avons recherché la présence de la résistance à l’insuline et la dysfonction endothéliale et leur relation aux facteurs de risqué vasculaire chez les patients migraineux.

Méthodes:

Nous avons évalué la résistance à l’insuline et la protéine c–réactive ultrasensible (hs–CRP), un marqueur de la dysfonction endothéliale, chez 60 patients migraineux et 25 sujets témoins normaux. L’analyse de covariance a été utilisée pour tenir compte des variables confondantes connues qui peuvent influencer le métabolisme de l’insuline et la fonction endothéliale, telles l’obésité, la tension artérielle et les valeurs de lipides.

Résultats:

La résistance à l’insuline mesurée par le HOMA–R était significativement plus élevée dans le groupe de patients migraineux (p < 0,001). Après avoir tenu compte des variables confondantes, la relation entre la migraine et le HOMA–R est demeurée significative (p < 0,001). Il n’existait pas de différence entre les niveaux de hs–CRP du groupe de patients migraineux et du groupe témoin.

Conclusions:

Cette étude démontre que la résistance à l’insuline est présente chez les patients migraineux. Quant à la dysfonction endothéliale, elle n’est pas présente pendant la période sans céphalée. Le rôle de la résistance à l’insuline dans la pathogenèse de la migraine devra faire l’objet d’études plus poussées.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 4 , September 2008 , pp. 448 - 451
Copyright
Copyright © The Canadian Journal of Neurological 2008

References

1. Lauritzen, M. Cerebral blood flow in migraine and cortical spreading depression. Acta Neurol Scand. 1987; 113 Suppl: 1–40.CrossRefGoogle ScholarPubMed
2. Welch, KM. Contemporary concepts of migraine pathogenesis. Neurology. 2003; 61 Suppl 4: 2–8.Google Scholar
3. Liew, G, Wang, JJ, Mitchell, P. Migraine and coronary heart disease mortality: a prospective cohort study. Cephalalgia. 2007; 4: 368–71.CrossRefGoogle Scholar
4. Kurth, T, Gaziano, JM, Cook, NR, Bubes, V, Logroscino, G, Diener, HC, et al. Migraine and risk of cardiovascular disease in men. Arch Intern Med. 2007; 167: 795–801.CrossRefGoogle ScholarPubMed
5. Agostoni, E, Fumagalli, L, Santoro, P, Ferrarese, C. Migraine and stroke. Neurol Sci. 2004; 25 Suppl 3: 123–5.Google Scholar
6. Scher, AI, Terwindt, GM, Picavet, HS, Verschuren, WM, Ferrari, MD, Launer, LJ. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology. 2005; 64: 614–20.CrossRefGoogle ScholarPubMed
7. Horev, A, Wirguin, I, Lantsberg, L, Ifergane, G. A high incidence of migraine with aura among morbidly obese women. Headache. 2005; 45: 936–8.CrossRefGoogle ScholarPubMed
8. Bigal, ME, Lipton, RB. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology. 2006; 67: 252–7.CrossRefGoogle Scholar
9. Bigal, ME, Liberman, JN, Lipton, RB. Obesity and migraine: a population study. Neurology. 2006; 66: 545–50.Google Scholar
10. Mclaughlin, T, Abbasi, F, Lamendola, C, Liang, L, Reaven, G, Schaaf, P, et al. Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation. 2002; 106: 2908–12.Google Scholar
11. Adam, FM, Nara, MG, Adam, JM. Fasting insulin, adiponectin, hs-CRP levels, and the components of metabolic syndrome. Acta Med Indones. 2006; 38: 179–84.Google ScholarPubMed
12. Headache Classification Sub-Committee of the International Headache Society. International classification of headache disorders. 2nd ed. Cephalalgia. 2004; 24: 1–160.Google Scholar
13. World Health Organization. Obesity: preventing and managing in global epidemic. Report of a WHO consultation on obesity. Geneva; June, 1997.Google Scholar
14. Matthews, DR, Hosker, JP, Rudenski, AS, Naylor, BA, Treacher, DF, Turner, RC. Homeostasis model assessment: insulin resistance and β cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28: 412–9.Google Scholar
15. Rainero, I, Limone, P, Ferrero, M, Valfre, W, Pelissetto, C, Rubino, E, et al. Insulin sensitivity is impaired in patients with migraine. Cephalalgia. 2005; 25: 593–7.CrossRefGoogle ScholarPubMed
16. Yudkin, JS. Insulin resistance and the metabolic syndrome-or the pitfalls of epidemiology. Diabetologia. 2007; 50: 1576–86.Google Scholar
17. Chan, JC, Tong, PC, Critchley, JA. The insulin resistance syndrome: mechanisms of clustering of cardiovascular risk. Semin Vasc Med. 2002; 2: 45–57.CrossRefGoogle ScholarPubMed
18. Mezei, Z, Kis, B, Gecse, A, Tajti, J, Boda, B, Telegdy, G, et al. Platelet arachidonate cascade of migraineurs in the interictal phase. Platelets. 2000; 11: 222–5.Google Scholar
19. Crassard, I, Conard, J, Bousser, MG. Migraine and homeostasis. Cephalalgia. 2001; 21: 630–6.CrossRefGoogle Scholar
20. Tietjen, GE, Al-qasmi, MM, Athanas, K, Dafer, RM, Khuder, SA. Increased von Willebrand factor in migraine. Neurology. 2001; 57: 334–6.Google Scholar
21. Cavestro, C, Rosatello, A, Micca, G, Ravotto, M, Marino, MP, Asteggiano, G, et al. Insulin metabolism is altered in migraineurs: a new pathogenic mechanism for migraine? Headache. 2007; 47: 1436–42.CrossRefGoogle ScholarPubMed
22. Kim, C, Siscovick, DS, Sidney, S, Lewis, CE, Kiefe, CI, Koepsell, TD. The CARDIA study. Oral contraceptive use and association with glucose, insulin, and diabetes in young adult women: coronary artery risk development in young adults. Diabetes Care. 2002; 25: 1027–32.Google Scholar
23. Drummond, PD, Lance, JW. Neurovascular disturbances in headache patients. Clin Exp Neurol. 1984; 20: 93–9.Google Scholar
24. Rasmussen, BK, Olesen, J. Migraine with aura and migraine without aura: an epidemiological study. Cephalalgia. 1992; 12: 221–8.Google Scholar
25. Di Napoli, M, Schwaninger, M, Cappelli, R, Ceccarelli, E, Di Gianfilippo, G, Donati, C, et al. Evaluation of C-reactive protein measurement for assessing the risk and prognosis in ischemic stroke: a statement for health care professionals from the CRP Pooling Project members. Stroke. 2005; 36: 1316–29.CrossRefGoogle ScholarPubMed
26. Shlipak, MG, Ix, JH, Bibbins-Domingo, K, Lin, F, Whooley, MA. Biomarkers to predict recurrent cardiovascular disease: the heart and soul study. Am J Med. 2008; 121: 50–7.Google Scholar
27. Welch, KM, Brandes, AW, Salerno, L, Brandes, JL. C-reactive protein may be increased in migraine patients who present with complex clinical features. Headache. 2006; 46: 197–9.CrossRefGoogle ScholarPubMed
28. Vanmolkot, FH, de Hoon, JN. Increased C-reactive protein in young adult patients with migraine. Cephalalgia. 2007; 27; 843–6.Google Scholar
29. Sjaastad, O, Bakketeig, LS. Migraine without aura: comparison with cervicogenic headache. Vågå study of headache epidemiology. Acta Neurol Scand. 2007 Nov 20; [Epub ahead of print].Google Scholar