Episodic migraine and obesity and the influence of age, race, and sex

Abstract

Objective: To evaluate the episodic migraine (EM)-obesity association and the influence of age, race, and sex on this relationship.

Methods: We examined the EM-obesity association and the influence of age, race, and sex in 3,862 adult participants of both black and white race interviewed in the National Comorbidity Survey Replication. EM diagnostic criteria were based on the International Classification of Headache Disorders. Body mass index was classified as underweight (<18.5 kg/m(2)), normal (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), or obese (≥30 kg/m(2)). Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for EM were estimated using logistic regression. Models were stratified by age (<50/≥50 years), race (white/black), and sex (male/female).

Results: A total of 188 participants fulfilled criteria for EM. In all participants, the adjusted odds of EM were 81% greater in individuals who were obese compared with those of normal weight (OR 1.81; 95% CI: 1.27-2.57; p = 0.001), with a significant trend of increasing odds of EM with increasing obesity status from normal weight to overweight to obese (p = 0.001). In addition, stratified analyses demonstrated that the odds of EM were greater in obese as compared with normal-weight individuals who were 1) younger than 50 years of age (OR 1.86; 95% CI: 1.20-2.89; p for trend = 0.008), 2) white (OR 2.06; 95% CI: 1.41-3.01; p for trend ≤0.001), or 3) female (OR 1.95; 95% CI: 1.38-2.76; p for trend ≤0.001).

Conclusion: The odds of EM are increased in those with obesity, with the strongest relationships among those younger than 50 years, white individuals, and women.

Figure. Adjusted total and stratified ORs and 95% CIs of episodic migraine in NCS-R participants who were overweight and obese

ORs are shown on a log scale; boxes represent the ORs and the horizontal bars the 95% CIs. Total = all NCS-R participants adjusted for age, race, sex, smoking, poverty index, depression, and diabetes; all other models are adjusted for smoking, poverty index, depression, and diabetes, as well as for age, race, and sex when not stratified on the variable. Older = 50 years and older; obese = BMI ≥30 kg/m²; over = overweight (BMI 25–29.9 kg/m²); younger = younger than 50 years. BMI = body mass index; CI = confidence interval; EM = episodic migraine; NCS-R = National Comorbidity Survey Replication; OR = odds ratio.