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Migraine and body mass index categories: a systematic review and meta-analysis of observational studies.

Ornello R, Ripa P, Pistoia F, Degan D, Tiseo C, Carolei A, Sacco S - J Headache Pain (2015)

Bottom Line: When considering the 11 studies following the World Health Organization BMI cutoffs, we found an increased risk of having migraine in underweight subjects (pooled adjusted effect estimate [PAEE] 1.21; 95% CI, 1.07-1.37; P = 0.002) and in obese women (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023) as compared with normal weight subjects; additionally, pre-obese subjects had an increased risk of having chronic migraine (PAEE 1.39; 95% CI, 1.13-1.71; P = 0.002).When considering all the 15 studies, we additionally found an increased risk of having migraine in obese as compared with normal weight subjects (PAEE 1.14; 95% CI, 1.02-1.27; P = 0.017); additionally, obese subjects had an increased risk of having chronic migraine (PAEE 1.75; 95% CI, 1.33-2.29; P < 0.001).The pooled analysis did not indicate an increased risk of having migraine in pre-obese subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Clinical Sciences and Biotechnology, Institute of Neurology, University of L'Aquila, 67100, L'Aquila, Italy. raffaele.ornello@gmail.com.

ABSTRACT

Background: Several studies have assessed the associations between migraine and underweight, pre-obesity or obesity, with conflicting results. To assess the consistency of the data on the topic, we performed a systematic review and meta-analysis of the available observational studies.

Methods: Multiple electronic databases were systematically searched up to October 2014 for studies assessing the association between migraine and body mass index categories (underweight, pre-obesity, or obesity).

Results: Out of 2,022 records, we included 15 studies. When considering the 11 studies following the World Health Organization BMI cutoffs, we found an increased risk of having migraine in underweight subjects (pooled adjusted effect estimate [PAEE] 1.21; 95% CI, 1.07-1.37; P = 0.002) and in obese women (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023) as compared with normal weight subjects; additionally, pre-obese subjects had an increased risk of having chronic migraine (PAEE 1.39; 95% CI, 1.13-1.71; P = 0.002). When considering all the 15 studies, we additionally found an increased risk of having migraine in obese as compared with normal weight subjects (PAEE 1.14; 95% CI, 1.02-1.27; P = 0.017); additionally, obese subjects had an increased risk of having chronic migraine (PAEE 1.75; 95% CI, 1.33-2.29; P < 0.001). The pooled analysis did not indicate an increased risk of having migraine in pre-obese subjects.

Conclusions: The meta-analysis of the available observational studies suggested an association between migraine and obesity likely mediated by gender and migraine frequency. Further studies taking into account gender, migraine type, frequency, activity, and duration could provide more robust evidence.

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Funnel plots of the risk of having any migraine in obese vs. normal weight women in studies fulfilling narrow inclusion criteria.
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Fig2: Funnel plots of the risk of having any migraine in obese vs. normal weight women in studies fulfilling narrow inclusion criteria.

Mentions: Five cross-sectional studies fulfilling the narrow inclusion criteria [54,56,59-61] investigated the risk of having migraine in obese subjects as compared with normal weight subjects. Two studies [59,61] found a significant association between the two variables, while the other three [54,56,60] did not find any association. Regarding women, two studies [59,61] found an increased risk of having any migraine in obese as compared with normal weight women while another study [56] did not find any association. In men, no increase was found in the risk of having any migraine in obese subjects as compared with normal weight subjects [56,59]. The pooled analysis did not suggest an increased risk of having migraine in obese as compared with normal weight subjects overall (PAEE 1.18; 95% CI, 0.99-1.41; P = 0.066), with substantial statistical heterogeneity (I2 = 75.3%; P = 0.003) (Figure 1). In obese women, the risk of having migraine was increased (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023), with substantial statistical heterogeneity (I2 = 78.0%; P = 0.011) (Figure 2), while the same risk was not increased in obese men (PAEE 1.04; 95% CI, 0.86-1.25; P = 0.715), with no statistical heterogeneity (I2 = 0%; P = 0.350) (Additional file 2).Figure 1


Migraine and body mass index categories: a systematic review and meta-analysis of observational studies.

Ornello R, Ripa P, Pistoia F, Degan D, Tiseo C, Carolei A, Sacco S - J Headache Pain (2015)

Funnel plots of the risk of having any migraine in obese vs. normal weight women in studies fulfilling narrow inclusion criteria.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385329&req=5

Fig2: Funnel plots of the risk of having any migraine in obese vs. normal weight women in studies fulfilling narrow inclusion criteria.
Mentions: Five cross-sectional studies fulfilling the narrow inclusion criteria [54,56,59-61] investigated the risk of having migraine in obese subjects as compared with normal weight subjects. Two studies [59,61] found a significant association between the two variables, while the other three [54,56,60] did not find any association. Regarding women, two studies [59,61] found an increased risk of having any migraine in obese as compared with normal weight women while another study [56] did not find any association. In men, no increase was found in the risk of having any migraine in obese subjects as compared with normal weight subjects [56,59]. The pooled analysis did not suggest an increased risk of having migraine in obese as compared with normal weight subjects overall (PAEE 1.18; 95% CI, 0.99-1.41; P = 0.066), with substantial statistical heterogeneity (I2 = 75.3%; P = 0.003) (Figure 1). In obese women, the risk of having migraine was increased (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023), with substantial statistical heterogeneity (I2 = 78.0%; P = 0.011) (Figure 2), while the same risk was not increased in obese men (PAEE 1.04; 95% CI, 0.86-1.25; P = 0.715), with no statistical heterogeneity (I2 = 0%; P = 0.350) (Additional file 2).Figure 1

Bottom Line: When considering the 11 studies following the World Health Organization BMI cutoffs, we found an increased risk of having migraine in underweight subjects (pooled adjusted effect estimate [PAEE] 1.21; 95% CI, 1.07-1.37; P = 0.002) and in obese women (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023) as compared with normal weight subjects; additionally, pre-obese subjects had an increased risk of having chronic migraine (PAEE 1.39; 95% CI, 1.13-1.71; P = 0.002).When considering all the 15 studies, we additionally found an increased risk of having migraine in obese as compared with normal weight subjects (PAEE 1.14; 95% CI, 1.02-1.27; P = 0.017); additionally, obese subjects had an increased risk of having chronic migraine (PAEE 1.75; 95% CI, 1.33-2.29; P < 0.001).The pooled analysis did not indicate an increased risk of having migraine in pre-obese subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Clinical Sciences and Biotechnology, Institute of Neurology, University of L'Aquila, 67100, L'Aquila, Italy. raffaele.ornello@gmail.com.

ABSTRACT

Background: Several studies have assessed the associations between migraine and underweight, pre-obesity or obesity, with conflicting results. To assess the consistency of the data on the topic, we performed a systematic review and meta-analysis of the available observational studies.

Methods: Multiple electronic databases were systematically searched up to October 2014 for studies assessing the association between migraine and body mass index categories (underweight, pre-obesity, or obesity).

Results: Out of 2,022 records, we included 15 studies. When considering the 11 studies following the World Health Organization BMI cutoffs, we found an increased risk of having migraine in underweight subjects (pooled adjusted effect estimate [PAEE] 1.21; 95% CI, 1.07-1.37; P = 0.002) and in obese women (PAEE 1.44; 95% CI, 1.05-1.97; P = 0.023) as compared with normal weight subjects; additionally, pre-obese subjects had an increased risk of having chronic migraine (PAEE 1.39; 95% CI, 1.13-1.71; P = 0.002). When considering all the 15 studies, we additionally found an increased risk of having migraine in obese as compared with normal weight subjects (PAEE 1.14; 95% CI, 1.02-1.27; P = 0.017); additionally, obese subjects had an increased risk of having chronic migraine (PAEE 1.75; 95% CI, 1.33-2.29; P < 0.001). The pooled analysis did not indicate an increased risk of having migraine in pre-obese subjects.

Conclusions: The meta-analysis of the available observational studies suggested an association between migraine and obesity likely mediated by gender and migraine frequency. Further studies taking into account gender, migraine type, frequency, activity, and duration could provide more robust evidence.

Show MeSH
Related in: MedlinePlus