Evaluation of serum uric levels in migraine

Oxidative Stress and Migraine

The pathogenesis of migraine is not completely understood, but inflammation and oxidative stress seem to be involved, according to data from an experimental model of the disease. This narrative review summarizes data from studies on oxidative stress markers in migraine patients, case-control association studies on the possible association of candidate genes related to oxidative stress with the risk for migraine, studies showing the presence of oxidative stress in experimental models of migraine, and studies on the efficacy of antioxidant drugs in migraine therapy. Many studies have addressed the value of concentrations of prooxidant and antioxidant substances or the activity of antioxidant enzymes in different tissues (mainly in serum/plasma or in blood cells) as possible biomarkers for migraine, being thiobarbituric acid (TBA) reactive substances (TBARS) such as malonyl dialdehyde acid (MDA) and 4-hydroxynonenal, and nitric oxide (this at least during migraine attacks in patients with migraine with aura (MWA) the most reliable. In addition, the possible usefulness of antioxidant treatment is not well established, although preliminary short-term studies suggest a beneficial action of some of them such as Coenzyme Q10 and riboflavin. Both topics require further prospective, multicenter studies with a long-term follow-up period involving a large number of migraine patients and controls.

Gout and Migraines: Exploring the Complex Link in a 16-Year Longitudinal Study of the Korean Population

Despite the growing prevalence of gout and its associated health concerns as a chronic disorder, population-based studies on its link to migraines are scarce. We conducted a 16-year longitudinal study in a Korean population to investigate the relationship between gout and migraines, including different subtypes. We enrolled 23,137 patients with gout and matched them with 92,548 controls based on age, sex, income, and residence. Using Cox proportional hazards models, we calculated hazard ratios to assess the likelihood of migraines while considering relevant factors. During the follow-up, 1000 gout patients and 3214 controls experienced migraines. After adjusting for various factors, including demographics, health-related variables, and weight categories, the gout group had a 1.26-fold higher likelihood of developing migraines compared to the group without gout. This association was particularly strong for migraines without aura, while it was not significant for migraines with aura. In summary, our study reveals a significant link between gout and migraines in the Korean population, emphasizing the complex relationship among chronic disorders, with a specific focus on migraine subtypes.

Migraine signaling pathways: purine metabolites that regulate migraine and predispose migraineurs to headache

Migraine is a debilitating disorder that afflicts over 1 billion people worldwide, involving attacks that result in a throbbing and pulsating headache. Migraine is thought to be a neurovascular event associated with vasoconstriction, vasodilation, and neuronal activation. Understanding signaling in migraine pathology is central to the development of therapeutics for migraine prophylaxis and for mitigation of migraine in the prodrome phase before pain sets in. The fact that both vasoactivity and neural sensitization are involved in migraine indicates that agonists which promote these phenomena may very well be involved in migraine pathology. One such group of agonists is the purines, in particular, adenosine phosphates and their metabolites. This manuscript explores what is known about the relationship between these metabolites and migraine pathology and explores the potential for such relationships through their known signaling pathways. Reported receptor involvement in vasoaction and nociception.

Decreased Serum Uric Acid Level as an Indicator of Altered Oxidative Balance in Patients With Migraine

INTRODUCTION

Migraine is one of the most common neurological diseases. The pathophysiology of migraine has not yet been fully elucidated. There is increasing evidence supporting the relationship between oxidative stress and migraine.

METHOD

This is a retrospective, cross-sectional and observational study. The patients were divided into two groups, episodic migraine and chronic migraine. Episodic migraine patients were divided into two subgroups, migraine with aura and migraine without aura. Serum Albumin, total bilirubin, uric acid levels, and migraine clinical findings were obtained from medical records.

RESULTS

A total of 181 participants, 88 patients and 93 controls, were included in the study. Serum albumin levels were lower in the patient group than in the control group, they did not reach statistical significance (p=0.082). There was no significant difference between the patient and control groups for total bilirubin levels (p=0.785). Serum uric acid levels in the patient group were found to be significantly lower than in the control group (p<0.001). Measured levels were similar in chronic and episodic migraine groups, and migraine with aura and migraine without aura subgroups.

CONCLUSION

We thought this oxidative stress marker may be associated with the presence of migraine, but this is not significant for migraine subtypes and migraine progression.

Evaluation of simple antioxidant blood parameters in patients with migraine

Background

The study aims to investigate the role of serum albumin (ALB) and creatinine (CRE), bilirubin (BIL), and uric acid (UA) as major intravascular antioxidants in migraine.

Methods

We enrolled 148 patients with migraine and 150 age- and sex-matched healthy controls. The serum levels of ALB, TBIL, CRE, and UA were measured in patients with migraine of different subtypes. The risk of migraine was assessed by multiple stepwise logistic regression analysis.

Results

The serum levels of ALB, total BIL (TBIL), CRE, and UA were significantly lower in the migraine group than in the HC group (p < 0.05). The ALB and UA levels were lower during migraine attack periods (p < 0.05). There were no statistically significant differences observed in serum ALB, TBIL, CRE, and UA levels between aura/without aura and episodic/chronic migraine subtypes (p > 0.05). The multiple stepwise logistic regression revealed that ALB [odds ratio (OR) 0.79, 95% confidence interval (CI) 0.69–0.89, p < 0.001], TBIL (OR 0.61, 95% CI 0.5–0.75, p < 0.001), and UA (OR 0.97, 95% CI 0.96–0.99, p = 0.014) were independently associated with migraine. In addition, the serum levels of ALB, TBIL, and UA were significantly lower in the migraine group when compared by sex.

Conclusion

The serum levels of UA, TBIL, ALB, and CRE were lower in the patients with migraine, indicating a lower antioxidant status. In addition, ALB, TBIL, and UA were independently related to migraine. These results could provide insights into the possible role of oxidative stress in the pathogenesis of migraine.

An Exponential Curve Relationship Between Serum Urate and Migraine: A Cross-Section Study From NHANES

Background

Migraine is a common neurological disease and an important cause of disability worldwide. Serum urate is the end product of purine metabolism in Homo sapiens and other hominoids. Previous studies about the serum urate level in migraine were contradictory. Hence, we present a cross-section study to clarify the association between serum urate and migraine and explore the dose effect of serum urate on migraine.

Materials and Methods

The data for this cross-section study were acquired from the National Health and Nutrition Examination Survey (NHANES). A diagnosis of migraine was made through patient the self-reported and prescription medication. For data analysis, the weighted linear regression model, weighted chi-square test, logistic regression models, smooth curve fittings, and the two-piecewise linear regression model were utilized for data analysis. All data analysis was conducted on Empower software.

Results

Totally, 18,637 participants were enrolled in this study, of which 208 were migraineurs. The rest were set as control. There existed a statistically significant difference in mean age (p = 0.0389), gender (p< 0.0001), race (p< 0.0001), data release cycle (p = 0.048), drug usage, blood albumin (p< 0.0001), blood total protein (p< 0.0001), hemoglobin (p< 0.0001), serum iron (p< 0.0001), and serum urate (p< 0.0001) between the two groups. According to logistic regression models, there existed no consistent linear relationship between serum urate and migraine before (model 1: odd ratio (OR) = 0.83, p = 0.0004) or after adjusting for confounders (model 2: OR = 0.96, p = 0.5198; model 3: OR = 0.84, p = 0.0184). However, smooth curve fittings found an exponential curve relationship between serum urate and migraine. Furthermore, when serum urate was more than 7.8 mg/dl, higher serum urate was correlated with higher migraine occurrence (model 1: OR = 1.54, p = 0.0022; model 2: OR = 1.51, p = 0.0050; model 3: OR = 1.77, p = 0.0348). Besides, 8 out of the 208 migraineurs had a serum urate higher than 7.8 mg/dl.

Conclusions

In conclusion, there existed an exponential curve relationship between serum urate and migraine, with an infliction point of 7.8 mg/dl. When serum urate was more than 7.8 mg/dl, increased serum urate was correlated with higher migraine occurrence.