Negative association between serum lutein/zeaxanthin levels and migraine in American adults: a retrospective study from NHANES

Migraine continues to be the dominant neurovascular disorder, impacting more than one billion individuals globally [1, 2], ranking as the second leading cause of disability based on the 2019 Global Burden of Disease, Injury, and Risk Factors Studies [2].Recent findings suggest that migraine is influenced by oxidative stress, neuroinflammation, and mitochondrial impairment, which are crucial factors in their development [1, 3-5].Previous research has consistently associated oxidative stress indicators with the development of migraine, such as 8-hydroxy-2-deoxyguanosine [6], superoxide dismutase, catalase, malondialdehyde [7], advanced oxidation protein products, ferric reducing antioxidant power, and thiol groups [4].Lutein and zeaxanthin are both carotenoids that possess significant antioxidant properties, which can protect cells from damage caused by free radicals.These free radicals can trigger oxidative stress, potentially contributing to the development of various diseases [8].Although considerable investigation has explored the positive effects of lutein/zeaxanthin on health [9][10][11], the specific relationship between serum lutein/ zeaxanthin levels and migraine is not well understood.We hypothesise that higher serum lutein/zeaxanthin levels may be inversely associated with the prevalence of migraine.To test this hypothesis, we conducted a study aimed at investigating the potential correlation between serum lutein/zeaxanthin levels and migraine occurrence among adults in the United States.Methods.This cross-sectional analysis made use of data that was publicly accessible from the National Health and Nutrition Examination Survey (NHANES) from the website (https://wwwn.cdc.gov/nchs/nhanes/default.aspx).We enrolled participants aged 20 years or older (n = 10,452) who had participated in an interview between 2001 and 2004.Ultimately, 8659 participants were included for further analysis (1734 with migraine vs. 6925 without migraine).Figure 1 illustrates the comprehensive procedure of participant inclusion and exclusion.Descriptions of laboratory protocols and quality assurance techniques for measuring serum lutein/zeaxanthin are available on the websites (https:// wwwn.cdc.gov/Nchs/Data/Nhanes/Public/2001/DataFiles/L06VIT_B.xpt and https://wwwn.cdc.gov/Nchs/Data/Nhanes/Public/2003/DataFiles/ L45VIT_C.xpt).Identification of the presence of migraine in participants was made according to their answers to the questions in the miscellane-OR -odds ratio, CI -confidence intervals, Ref -reference.