Prevalence of migraine is higher in men and women who have total body obesity (TBO) or abdominal obesity (Abd-O), according to the results of a study by Lee B. Peterlin, DO, assistant professor in the Department of Neurology, and colleagues at Drexel University College of Medicine in Philadelphia.1
While previous studies have shown that TBO may be associated with migraine chronification, data have been conflicting as to whether TBO or Abd-O are associated with migraine prevalence, said Peterlin. Abd-O is much more prevalent than TBO, and Abd-O has been shown to be a better predictor of disease than TBO in disorders such as cardiovascular disease and diabetes.
Peterlin’s team reviewed data from the National Health and Nutrition Examination Survey on 10,623 men and 11,160 women, including reports of migraine severity and body mass information that had been measured by a health care provider. TBO was defined as body mass index (BMI) of 30 or higher, and Abd-O was defined as a waist circumference of 88 cm or more in women and 102 cm or more in men.
TBO was found in 27.7% of men and in 32.3% of women ages 20 to 55 years, and Abd-O was found in 35% of men and in 53.2% of women in this age-group. The prevalence of migraine was higher in men with TBO (20.2%) than in those without TBO (16.1%), and this prevalence was significantly higher in women with TBO (39.1%) than in those without TBO (30.2%). Similarly, migraine prevalence in those with and without Abd-O was as follows: men, 20.1% versus 15.9%, and women, 36.9% versus 28.8%, respectively.
However, Peterlin’s team found that women older than 55 years with Abd-O had a decreased migraine prevalence (14.4% vs 17.4%). “In order to understand these findings, physicians need to understand previous epidemiological data evaluating obesity in the elderly and how adipose tissue is distributed differently in men and women,” said Peterlin.
Multiple previous studies have shown that in geriatric or elderly populations, BMI either is not associated or is associated negatively with mortality2 and studies have shown that BMI and waist circmference findings in women ages 55 to 59 years are not associated with mortality.3
Peterlin said there is a second hypothesis, which she favors. Age and sex hormones influence adipose tissue distribution. Men deposit this tissue centrally from puberty and throughout life. In women, adipose tissue is deposited in the gluteofemoral region during puberty but after menopause, the pattern shifts and tissue may be deposited centrally. Differences in adipose tissue distribution and the ratio of adipose tissue in the abdominal region may affect cytokine and adipocytokine production, contributing to the gender and age differences in migraine prevalence.
1. Peterlin LB, Rosso AL, Rapoport AM, Scher AI. Prevalence of migraine in abdominal obesity throughout the adult life-cycle: NHANES 1999-2004. [S46.004] Scientific Sessions: Headache: Basic and Clinical Science, Thursday, April 30, 2009.
2. Heiat A, Vaccarino V, Krumholz HM. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med. 2001;161:1194-1203.
3. Folsom AR, Kushi LH, Anderson KE, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women’s Health Study. Arch Intern Med. 2000;160:2117-2128.