Fasting lipid and lipoproteins concentrations in pregnant women with a history of migraine.
Fasting lipid and lipoproteins concentrations in pregnant women with a history of migraine.
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DOI：
10.1111/head.12571
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发表时间：
2015-05
期刊：
影响因子：
5
通讯作者：
Williams MA
中科院分区：
文献类型：
--
作者：
Gelaye B;Larrabure-Torrealva GT;Qiu C;Luque-Fernandez MA;Peterlin BL;Sanchez SE;Williams MA
偏头痛与许多心脏代谢危险因素有关，包括脂质代谢异常。然而，对怀孕偏头痛患者的这些关联知之甚少。我们进行了目前的研究，以评估血脂变化与孕妇偏头痛病史的关联程度。一组1062名秘鲁妇女在妊娠24-28周接受了采访。根据国际头痛疾病分类（ICHD-2）诊断标准对偏头痛状态进行分类。采用标准化测定法测定血清脂质浓度。多变量logistic回归用于估计校正优势比（AORs）和95%置信区间（CIs），作为偏头痛状态与妊娠期间不同浓度的脂质和脂蛋白的关联测量。大约18.5%的研究参与者被确定为偏头痛患者（1062人中有196人）。妊娠偏头痛患者血清总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、总胆固醇：HDL比值均高于妊娠非偏头痛患者。在多变量调整模型中，与没有偏头痛的孕妇相比，偏头痛孕妇总胆固醇、低密度脂蛋白和总胆固醇：高密度脂蛋白比值升高的几率更高。例如，总胆固醇与偏头痛病史相关的连续四分位数的AOR和95% CI分别为Q2 (219-247 mg/dL): 1.05 (0.64-1.70), Q3 (248-281mg/dL): 1.16 (0.72-1.86), Q4(≥282mg/dL): 1.87(1.20-2.91)，其中最低四分位数（<219 mg/dL）为参照组（趋势p值= 0.003）。与总胆固醇水平较低（< 219 mg/dL）的非肥胖女性相比，总胆固醇水平升高（≥282 mg/dL）的肥胖女性更容易患偏头痛（OR=3.71; 95% CI 1.58-8.71）。在低密度脂蛋白胆固醇升高、甘油三酯升高和总胆固醇：高密度脂蛋白比值高的肥胖妇女中，偏头痛的几率也出现了类似的升高。与非偏头痛孕妇相比，妊娠偏头痛患者血脂异常的几率更高，尤其是高胆固醇血症、低密度脂蛋白升高、总胆固醇：高密度脂蛋白比值升高。观察到的关联在肥胖偏头痛患者中更为明显。我们的研究结果增加了偏头痛患者不良心脏代谢风险概况的累积证据，并将这些关联扩展到孕妇。
Migraine is associated with a number of cardio-metabolic risk factors including abnormalities in lipid metabolism. However, little is known about these associations among pregnant migraineurs. We conducted the present study to evaluate the extent to which altered lipid profiles are associated with history of migraine among pregnant women. A cohort of 1,062 Peruvian women were interviewed at 24-28 weeks of gestation. Migraine status was classified based on the International Classification of Headache Disorders (ICHD-2) diagnostic criteria. Serum lipid concentrations were measured enzymatically using standardized assays. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) as measures of associations of migraine status with varying concentrations of lipids and lipoproteins during pregnancy. Approximately 18.5% of the study participants were identified as migraineurs (196 of 1,062). Maternal serum total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, and total cholesterol:HDL ratio were all statistically significantly elevated among pregnant migraineurs compared with pregnant non-migraineurs. In multivariate adjusted models pregnant women with migraine had higher odds of elevated total cholesterol, LDL, and total cholesterol:HDL ratio as compared with pregnant women without migraine. For instance the AOR and 95% CI for successive quartiles of the total cholesterol associated with history of migraine were Q2 (219-247 mg/dL): 1.05 (0.64-1.70), Q3 (248-281mg/dL): 1.16 (0.72-1.86), and Q4 (≥282mg/dL): 1.87 (1.20-2.91) with the lowest quartile (<219 mg/dL) as the referent group (p-value for trend= 0.003). Obese women with elevated total cholesterol (≥282 mg/dL) were more likely to be migraineurs (OR=3.71; 95% CI 1.58-8.71) as compared with non-obese women with lower total cholesterol (< 219 mg/dL). Similar elevated odds of migraine were observed for obese women with elevated LDL cholesterol, elevated triglycerides and high total cholesterol:HDL ratio. Pregnant migraineurs had elevated odds of dyslipidemia, particularly hypercholesterolemia, elevated LDL, and total cholesterol:HDL ratio as compared with pregnant non-migraineurs. The observed associations were more pronounced among obese migraineurs. Our findings add to the accumulating evidence of adverse cardiometabolic risk profiles among migraineurs and extends these associations to pregnant women.
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