Insulin metabolism is altered in migraineurs: a new pathogenic mechanism for migraine?
BACKGROUND
Migraine is a complex biochemical dysfunction attributed to a disorder of the trigeminal and hypothalamic pathways. Impairment of glucose metabolism has been reported in migraine, but data are scanty and inconsistent.


OBJECTIVE
The main aim was to verify whether migraineurs have abnormalities of the glucose and insulin metabolism. We also studied correlations between blood glucose and insulin and between insulin levels and migraine severity.


METHODS
Patients with migraine or headache other than migraine, and healthy volunteers were included. All had general blood tests and a standard oral glucose tolerance test after a 12-hour fast, and glucose and insulin were measured.


RESULTS
Over a 6-month period, we recruited 84 migraineurs (73 women, 11 men), 25 patients with nonmigraine headache (20 women, 5 men), and 26 healthy controls (24 women, 2 men). Multivariate analysis confirmed a significant difference between groups for glucose levels (P < .0001), but no significant time interaction. The differences were mostly between migraine and healthy controls (P < .0001) and to a lesser extent between other headaches and healthy controls (P < .05). A significant difference between groups was also found for insulin (P < .0001), with a significant time interaction. The difference was confirmed for migraine compared to other headaches (P < .0001) and healthy controls (P < .0001).


CONCLUSIONS
Blood glucose levels may be high in headache patients, but do not seem to be specific to migraineurs. Insulin levels were higher in migraineurs, and seemed specific to this group. These findings are in keeping with recent reports on the effects of insulin on brain functions and lend support to the possibility that insulin is involved in the pathogenesis of migraine.
Headache Center, Department of Neurology, San Lazzaro Hospital, Alba, Italy.
Cinzia
C
Cavestro
Annalisa
A
Rosatello
GianMatteo
G
Micca
Marisa
M
Ravotto
Maria Pia
MP
Marino
Giovanni
G
Asteggiano
Ettore
E
Beghi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D005260:Female; D005951:Glucose Tolerance Test; D006261:Headache / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin