Patients with migraines may have higher total cholesterol (TC) and triglyceride (TG) concentrations than healthy patients with comparable body mass index values (BMI). This emerges from the study results published in Headache.
The study researchers conducted a systematic review consisting of the initial meta-analysis to quantify differences in lipid profiles in patients with migraines (both with) [MWA] and without [MWoA] Auras) and healthy controls (HC) in individuals who are naive to lipid lowering agents and have no known history or secondary causes of dyslipidemia (apart from subjectively assessed lifestyle parameters).
They searched multiple databases for case-control, cross-sectional, and cohort studies published prior to September 15, 2020 that included HC and migraine sufferers who were diagnosed with TC, TG, serum low-density lipoprotein (LDL-C ) or high density values reported. Density lipoprotein cholesterol (HDL-C). Study participants had no known dyslipidemias or secondary causes of dyslipidemias. Researchers selected 16 case-control and 1 cross-sectional adult study and performed subgroup analyzes of migraine type and head-to-head comparisons.
Patients with migraines had higher serum TC levels based on the mean difference (MD) in 14 studies (P <0.1; I2, 85%; MD, 10.6 mg / dL; 95% CI, 1.8 -19.3). MD in 15 combined studies showed that people with migraines had significantly higher TG levels than their HC counterparts (P <0.1; I2, 67%; MD, 11.8 mg / dL; 95% CI, 3.6 -20.0), which was also observed in sensitivity analyzes. However, the TG values for the migraine groups did not exceed the threshold value of 2 mmol / l (about 177 mg / dl). In patients with such TG levels, reductions of as little as 0.1 mmol / L (about 8.9 mg / dL) may be of clinical benefit. There was no significant difference between patients with MWA and patients with MWoA for either TC or TG.
Compared to the HC group, patients with migraines had similar HDL-C levels, as shown by the MD in 14 studies (P <0.1; I2, 70%; MD, -0.4 mg / dl; 95% CI , -2.2-1.5 [for mmol/L multiply by 0.0259]), which could also be seen in sensitivity analyzes and subgroup analyzes.
In the sensitivity analysis, after excluding studies that did not show comparable BMI values between the groups, there was no significant difference in LDL-C between patients with migraine and HC (P <0.1; I2, 70%; MD, 5, 3 mg / dl; 95)% CI, -0.1-10.8). Subgroup analyzes according to the type of migraine also showed no difference between the two groups ([for MWA: P <0.1; I2, 93%; MD, 16.9 mg/dl, 95% CI, -4.6-38.3];; [for MWoA: P <0.1; I2, 96%; MD, 14.0 mg/dl, 95% CI, -4.0-32.0]).
Study limitations may include limited generalizability, as most of the studies accessed were conducted in Turkey, the exclusion of a case-control study that indicated higher LDL-C levels in migraineurs, and the possibility that migraineurs had one are biased sample.
The study’s researchers concluded, “TC abnormalities may provide part of the explanation for the adverse cardiovascular profile of migraineurs.” “Lifestyle,” they added, “may be partly or wholly responsible for the particular elevated serum TC. Additional studies fully exploring the effect of lifestyle parameters on lipid concentration are needed to better understand existing abnormalities. ”
Liampas I., Mylonas KS, Brotis A. et al. Serum lipid abnormalities in migraines: a meta-analysis of observational studies. A headache. Published online January 4, 2021. doi: 10.1111 / head.14039