SP25. The Association between Obesity and Migraine: Does This Exist?

Abstract

PURPOSE: Migraine headaches are a chronic disease for millions worldwide. Metabolic syndrome including obesity and hypertension are hypothesized to be linked to an increased prevalence of migraine and to an increased migraine attack frequency. The aim of this study was to evaluate the association between obesity, menopausal status and migraine characteristics. METHODS: In this retrospective chart review, data from medical records between July 2013-July 2022 of patients who presented with migraine headache at the plastic and reconstructive surgery department at The Ohio State University were reviewed. Demographic data, body mass index (BMI) and blood pressure were recorded. Migraine headache characteristics were extracted and the migraine headache index (MHI) was calculated. The MHI was calculated by multiplying frequency, duration and intensity of migraine headaches. Univariate linear regression models were used to evaluate the associations between measures of migraine, metabolic syndrome and menopausal status. RESULTS: A total of 211 patients with migraine headaches were identified. Seventy-eight percent were female and 22% were male, with an average age of 44.6±12.8 years (average ± SD). Center for Disease Control and Prevention (CDC) classification of BMI was used. Higher MHI and number of headaches per month were significantly associated with class 3 obesity (BMI >40, p<0.01), but not with other BMI classes (p>0.05). Intensity and duration of headaches were not associated with BMI, respectively (p>0.05). Postmenopausal status was associated with a significantly lower number of migraines per month (p=0.02). Hypertension was not associated with migraine characteristics (p>0.05). CONCLUSION: A higher BMI is associated with increased MHI and frequency of migraines, but not with the intensity and duration of headaches experienced. Furthermore, number of headaches decreased after menopause. As fat mass increases in obesity, aromatase expression and consequently estrogen levels are also elevated, which impacts migraine headaches. Moreover, higher BMI may also impact compression neuropathy. These findings provide new insights into the association between obesity and migraine headaches. Future multicenter studies are needed to explore these associations in a larger group of patients.