Factors Associated with Insulin Resistance in Women with Migraine: A Cross-Sectional Study

Pain Med. 2019 Oct 1;20(10):2043-2050. doi: 10.1093/pm/pnz055.

Abstract

Objective: Studies have shown a relationship between insulin resistance (IR) and migraine that is more evident in some migraineurs. Long-term use of various drugs and increased risk of diverse side effects is an unavoidable reality in this population of patients. Thus, in this study, we aimed to investigate factors associated with IR in migraine and the impact of chronic usage of various drugs, which might play a part in development of IR.

Design: Cross-sectional study.

Setting: Gebze Fatih General Hospital, Kocaeli, Turkey.

Subjects: Migraine patients (N = 150) were investigated.

Methods: Weight, height, waist circumference, and blood pressure were measured. Fasting glucose, fasting insulin, glycated hemoglobin, and lipid profile were also measured. IR was selected as a dependent variable. The independent variables included age, cigarette smoking, alcohol consumption, family history of migraine, diabetes mellitus and hypertension, characteristics of pain, migraine triggers and subgroups, medication used during attack treatment, medication used as prophylactic treatment, and oral contraceptive treatment. Descriptive analysis and multivariate logistic regression were performed.

Results: Central obesity (odds ratio [OR] = 7.131, 95% confidence interval [CI] = 2.451-20.741, P < 0.0001), metoclopramide treatment during an attack (OR = 3.645, 95% CI = 0.996-13.346, P = 0.041), family history of DM (OR = 3.109, 95% CI = 1.189-8.132, P = 0.035), nonsteroidal anti-inflammatory drug (NSAID) usage during an attack (OR = 2.578, 95% CI = 1.053-6.311, P = 0.043), and negative family history of hypertension (OR = 0.226, 95% CI = 0.085-0.602, P = 0.002) were significant factors for exhibiting IR in migraine.

Conclusions: Our study demonstrates an association between metoclopramide and NSAID treatments and IR in migraine.

Keywords: Insulin Resistance; Metoclopramide; Migraine; NSAIDs.

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Blood Glucose
  • Blood Pressure
  • Body Composition
  • Body Mass Index
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / genetics
  • Insulin Resistance*
  • Metoclopramide / adverse effects
  • Migraine Disorders / complications*
  • Migraine Disorders / epidemiology
  • Migraine Disorders / metabolism
  • Obesity, Abdominal / complications
  • Risk Factors
  • Waist Circumference

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Blood Glucose
  • Metoclopramide