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

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/m2), normal (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), or obese (≥30 kg/m2). 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. BMI= : body mass index; CI= : confidence interval; DSM-IV = : Diagnostic and Statistical Manual of Mental Disorders , 4th edition; EM= : episodic migraine; ICHD-II= : International Classification of Headache Disorders, 2nd edition; LF-EM= : lower-frequency episodic migraine; NCS-R= : National Comorbidity Survey Replication; OR= : odds ratio; VAT= : visceral adipose tissue; VLF-EM= : very low-frequency episodic migraine