FOR
SEVERE HEADACHE OR MIGRAINE BY
SERUM
VITAMIN D STATUS: A CROSS-SECTIONAL
POPULATION-BASED STUDY
Disusun Oleh :
INTRODUCTIO
N
Use of statin medications has been associated with both increased and
decreased risk for migraine and headache.
Low vitamin D
status
Higher prevalence
of experiencing
severe headache
or migraine
Higher vitamin D
status
Lower prevalence
of experiencing
severe headache
or migraine
METHODS
OTHER COVARIATES
Principal
confounders
previously known or
suspected
to
be
associated with statin use
or
to
affect
the
relationship
between
statin use and vitamin D
Use of
specif
c pain
relief
Age
Sex
Number of
concurren
t
medicatio
n use
Ethnici
ty/race
Numbe
r of
times
seen
by
doctor
Educati
onal
attain
ment
Confou
nders
Selfreporte
d
health
status
History
of
stroke
Corona
ry
heart
diseas
e
Physic
al
activity
Body
mass
index
(BMI)
Alcohol
intake
Smokin
g
Self
Self report
report
depression/anxi
depression/anxi
ety/emotional
ety/emotional
problem
problem
Diabetes
Diabetes
Systolic
Systolic blood
blood
pressure
pressure
Do
Do they
they
influenced
influenced
our
our
result??
result??
Use
Use of
of
preventive
preventive
migraine
migraine
therapy
therapy
Post
Post
menopausal
menopausal
status/
status/
exogenous
exogenous
hormone
hormone
Cardiovascular
medications
(except for statin and aspirin)
were removed from the main
model to avoid redundancy
Performed
analyses
restricting models (1) to
age greater than 55 years,
and (2) to women 40
years, while adding a
variable
for
use
of
estrogen-containing
contraceptives or HCT
RESULTS
We found:
o
DISCUSSION
This study is based on the association between migraine with aura and the
risk for developing vascular disease, most notably stroke and suggested
associations between vascular diseases and any migraine, although the latter
remains controversial
Increased
Increased
interleukin
interleukin
(IL)-1)
(IL)-1)
Increased
Increased
plasminogen
plasminogen
activator
activator antigen
antigen
Increased
Increased
thrombosis
thrombosis (von
(von
Willebrand
factor
Willebrand factor
(vWF)
(vWF) activity
activity
Alterations
Alterations in
in the
the
nitric
nitric oxide
oxide
pathway
pathway
it seems unlikely that statins might decrease migraine via a direct action
on cholesterol reduction, suggesting further investigations on lipid
independent actions would be of most interest
Included
40
Included only
only people
people 40
years
years in
in order
order to
to evaluate
evaluate
statin
statin use
use
may
may not
not be
be
generalizable
to
younger
generalizable to younger
individuals
individuals
This
This study
study cannot
cannot address
address
causality
or
causality or the
the direction
direction of
of
the
the association
association we
we
observed
observed between
between statin
statin
use
and
vitamin
use and vitamin D
D with
with
lower
lower prevalence
prevalence of
of severe
severe
headache
headache or
or migraine.
migraine.
Although
Although we
we adjusted
adjusted
for
several
for several
confounders,
confounders, residual
residual
confounding
confounding may
may
exist
exist
Our
Our findings
findings of
of dichotomized
dichotomized
versus
versus linear
linear models
models of
of
25(OH)D
are
consistent
25(OH)D are consistent with
with
the
the notion
notion that
that the
the effect
effect of
of
25(OH)D
25(OH)D on
on statin
statin use
use is
is
nonlinear
nonlinear
Outcome
Outcome
based
based on
on selfselfreport
report
Although
Although 25(OH)D
25(OH)D
showed
showed a
a normal
normal
distribution,
distribution, the
the range
range
was
was relatively
relatively narrow,
narrow,
which
which prevented
prevented us
us from
from
examining
higher
examining higher levels
levels
STUDY LIMITATION
CONCLUSION
Clinical implications
. Statins have a variable effect on the prevalence of
severe headache or migraine that depends on vitamin D
status.
. Statin use in those with higher serum vitamin D levels
is significantly associated with a lower prevalence of
having severe headache or migraine.
THANK YOU