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Increased epicardial fat thickness and carotid intima–media thickness in migraine patients

  • Hikmet SaçmacıEmail author
  • Yaşar Turan
Original Article

Abstract

Background

Migraine is a common and debilitating neurological disorder characterized with episodic attacks. Epicardial fat is metabolically active and is an important predictor of metabolic and vascular diseases. We aimed to examine whether the echocardiographic measurement of epicardial fat thickness (EFT) and carotid intima–media thickness (CIMT) is increased in patients with episodic migraine (EM).

Methods

We studied 96 volunteers, including 48 patients with EM (mean age 40.10 ± 10 years, 41 female patients) and 48 healthy subjects (mean age 42.69 ± 10 years, gender is the same). All necessary biochemical parameters were analyzed; subsequently, EFT and CIMT were measured in all subjects. The migraine characteristics of the patients were questioned in detail.

Results

The patients with EM had a significantly higher EFT than the control group (5.34 ± 1.02 vs. 4.41 ± 0.68; P < 0.001) and CIMT was also found to be high (median 6.70 vs. 5.60; P < 0.001). Furthermore, there was a positive correlation between EFT and duration of disease and monthly frequency (r = 0.730; P < 0.001). EFT was significantly correlated with CIMT in the migraineurs (P < 0.001). As an optimal cut-off point, a high-risk EFT value of 5.54 mm was determined to predict EM, with 58.3% sensitivity and 96.8% specificity.

Conclusion

We found that EFT and CIMT were significantly higher in EM patients than in healthy individuals. Increased EFT may be a new risk factor in migraine patients especially in patients with increased pain frequency.

Keywords

Migraine Subclinical atherosclerosis Endothelial dysfunction Epicardial fat thickness Disease progression 

Notes

Compliance with ethical standards

Our study was approved by the Ethics Committee protocol (protocol number: 2017-KAEK189_2017.06.21_03) and all the participants provided written informed consent.

Conflict of interests

The authors declare that they have no conflict of interest.

References

  1. 1.
    Tietjen GE, Khubchandani J (2015) Vascular biomarkers in migraine. Cephalalgia. 35(2):95–117CrossRefGoogle Scholar
  2. 2.
    Arnold M (2018) Headache classification committee of the international headache society (ihs) the international classification of headache disorders. Cephalalgia. 38(1):1–211CrossRefGoogle Scholar
  3. 3.
    Grazzi L, D’Amico D (2019) Chronic migraine and medication overuse: which strategy for a complex scenario. Neurol Sci:1–2Google Scholar
  4. 4.
    Natoli J, Manack A, Dean B, Butler Q, Turkel CC, Stovner L Lipton RB (2010) Global prevalence of chronic migraine: a systematic review. Cephalalgia, 30(5):599-609.  https://doi.org/10.1111/j.1468-2982.2009.01941.x
  5. 5.
    Buse DC, Greisman JD, Baigi K, Lipton RB (2019) Migraine progression: a systematic review. Headache 59(3):306–338CrossRefGoogle Scholar
  6. 6.
    Dominguez C, Vieites-Prado A, Perez-Mato M, Sobrino T, Rodriguez-Osorio X, Lopez A et al (2018) Role of adipocytokines in the pathophysiology of migraine: a cross-sectional study. Cephalalgia. 38(5):904–911CrossRefGoogle Scholar
  7. 7.
    Gürdal A, Keskin K, Orken DN, Baran G, Kiliçkesmez K (2018) Evaluation of epicardial fat thickness in young patients with embolic stroke of undetermined source. Neurologist 23(4):113–117CrossRefGoogle Scholar
  8. 8.
    Iacobellis G (2015) Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 11(6):363–371CrossRefGoogle Scholar
  9. 9.
    Şengül C, Özveren O (2013) Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg 13(3):261–265Google Scholar
  10. 10.
    Magalhães JE, Barros IMLD, Pedrosa RP, Sampaio Rocha-Filho PA (2019) Migraine and markers of carotid atherosclerosis in middle-aged women: a cross-sectional study. Headache 59(1):77–85CrossRefGoogle Scholar
  11. 11.
    Avci AY, Akkucuk MH, Torun E, Arikan S, Can U, Tekindal MA (2019) Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study. Neurol Sci:1–9Google Scholar
  12. 12.
    Larsen JS, Skaug E-A, Wisløff U, Ellingsen Ø, Stovner LJ, Linde M, Hagen K (2016) Migraine and endothelial function: the HUNT3 study. Cephalalgia. 36(14):1341–1349CrossRefGoogle Scholar
  13. 13.
    Niddam DM, Lai K-L, Tsai S-Y, Lin Y-R, Chen W-T, Fuh J-L et al (2017) Neurochemical changes in the medial wall of the brain in chronic migraine. Brain. 141(2):377–390CrossRefGoogle Scholar
  14. 14.
    Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB (2008) Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache 48(8):1157–1168CrossRefGoogle Scholar
  15. 15.
    Scher A, Stewart W, Ricci J, Lipton RB (2003) Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 106(1–2):81–89CrossRefGoogle Scholar
  16. 16.
    Melzack R (1987) The short-form McGill pain questionnaire. Pain. 30(2):191–197CrossRefGoogle Scholar
  17. 17.
    Report of a WHO Expert Committee (1995) Physical status: the use and interpretation of anthropometry. World Health Organ Tech Rep Ser 854:1–452Google Scholar
  18. 18.
    Hirata Y, Kurobe H, Akaike M, Chikugo F, Hori T, Bando Y, Nishio C, Higashida M, Nakaya Y, Kitagawa T, Sata M (2011) Enhanced inflammation in epicardial fat in patients with coronary artery disease. Int Heart J 52(3):139–142CrossRefGoogle Scholar
  19. 19.
    Iacobellis G, Ribaudo MC, Assael F, Vecci E, Tiberti C, Zappaterreno A, di Mario U, Leonetti F (2003) Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 88(11):5163–5168CrossRefGoogle Scholar
  20. 20.
    Gürel G, Turan Y2 (2019) Noninvasive assessment of subclinical atherosclerosis in patients with rosacea. G Ital Dermatol Venereol.  https://doi.org/10.23736/S0392-0488.19.06218-7
  21. 21.
    Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, Sarov-Blat L, O’Brien S, Keiper EA, Johnson AG, Martin J, Goldstein BJ, Shi Y (2003) Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 108(20):2460–2466CrossRefGoogle Scholar
  22. 22.
    Nagy E, Jermendy AL, Merkely B, Maurovich-Horvat P (2017) Clinical importance of epicardial adipose tissue. Arch Med Sci 13(4):864CrossRefGoogle Scholar
  23. 23.
    Cabrera-Rego JO, Iacobellis G, Castillo-Herrera JA, Valiente-Mustelier J, Gandarilla-Sarmientos JC, Marín-Juliá SM, Navarrete-Cabrera J (2014) Epicardial fat thickness correlates with carotid intima-media thickness, arterial stiffness, and cardiac geometry in children and adolescents. Pediatr Cardiol 35(3):450–456CrossRefGoogle Scholar
  24. 24.
    Sacco S, Merki-Feld GS, Ægidius KL, Bitzer J, Canonico M, Kurth T et al (2017) Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC). J Headache Pain 18(1):108CrossRefGoogle Scholar
  25. 25.
    Butt JH, Franzmann U, Kruuse C (2015) Endothelial function in migraine with aura–a systematic review. Headache 55(1):35–54CrossRefGoogle Scholar
  26. 26.
    Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER et al (2008) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 21(2):93–111CrossRefGoogle Scholar
  27. 27.
    Goulart AC, Santos IS, Bittencourt MS, Lotufo PA, Benseñor IM (2016) Migraine and subclinical atherosclerosis in the Brazilian longitudinal study of adult health (ELSA-Brasil). Cephalalgia. 36(9):840–848CrossRefGoogle Scholar
  28. 28.
    Ameijeira P, Leira Y, Blanco J, Leira R (2017) Periodontal disease as a potential factor of migraine chronification. Med Hypotheses 102:94–98CrossRefGoogle Scholar
  29. 29.
    Kim M-K, Tomita T, Kim M-J, Sasai H, Maeda S, Tanaka K (2009) Aerobic exercise training reduces epicardial fat in obese men. J Appl Physiol 106(1):5–11CrossRefGoogle Scholar
  30. 30.
    Natale F, Tedesco MA, Mocerino R, de Simone V, Di Marco GM, Aronne L et al (2009) Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr 10(4):549–555CrossRefGoogle Scholar

Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Department of Neurology, Faculty of MedicineBozok UniversityYozgatTurkey
  2. 2.Department of Cardiology, Faculty of MedicineBozok UniversityYozgatTurkey

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