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May 09, 2017; 88 (19) Article

Body composition status and the risk of migraine

A meta-analysis

Bizu Gelaye, Simona Sacco, Wendy J. Brown, Haley L. Nitchie, Raffaele Ornello, B. Lee Peterlin
First published April 12, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003919
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Abstract

Objective: To evaluate the association between migraine and body composition status as estimated based on body mass index and WHO physical status categories.

Methods: Systematic electronic database searches were conducted for relevant studies. Two independent reviewers performed data extraction and quality appraisal. Odds ratios (OR) and confidence intervals (CI) were pooled using a random effects model. Significant values, weighted effect sizes, and tests of homogeneity of variance were calculated.

Results: A total of 12 studies, encompassing data from 288,981 unique participants, were included. The age- and sex-adjusted pooled risk of migraine in those with obesity was increased by 27% compared with those of normal weight (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.16–1.37, p < 0.001) and remained increased after multivariate adjustments. Although the age- and sex-adjusted pooled migraine risk was increased in overweight individuals (OR 1.08; 95% CI 1.04, 1.12, p < 0.001), significance was lost after multivariate adjustments. The age- and sex-adjusted pooled risk of migraine in underweight individuals was marginally increased by 13% compared with those of normal weight (OR 1.13; 95% CI 1.02, 1.24, p < 0.001) and remained increased after multivariate adjustments.

Conclusions: The current body of evidence shows that the risk of migraine is increased in obese and underweight individuals. Studies are needed to confirm whether interventions that modify obesity status decrease the risk of migraine.

GLOSSARY

BMI=
body mass index;
CI=
confidence interval;
HUNT-2=
second Health Survey of Nord-Trondelag County;
ICHD=
International Classification of Headache Disorders;
IL=
interleukin;
NOS=
Newcastle-Ottawa Scale;
OR=
odds ratio

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received October 28, 2016.
  • Accepted in final form February 14, 2017.
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Letters: Rapid online correspondence

  • Author response to Dr. Gupta
    • Bizu Gelaye, PhD, Harvard T. H. Chan School of Public Health
    • Simona Sacco, MD, Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila
    • Wendy Brown, PhD, University of Queensland, School of Human Movement and Nutrition Sciences (Brisbane, Australia)
    • Haley Nitchie, BS, Johns Hopkins University School of Medicine, Department of Neurology (Baltimore, MD)
    • Raffaele Ornello, MD, Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila
    • B. Lee Peterlin, DO, Lancaster General Health (Lancaster, PA)
    Submitted September 10, 2018
  • Vagaries of meta-analysis: Migraine attacks increase with high and low BMI
    • Vinod K. Gupta, Physician, Medical Director, Gupta Medical Center
    Submitted April 29, 2018
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