他汀类药物使用与血清维生素D状态导致的严重头痛或偏头痛风险的关联：一项基于人群的横断面研究。

Association of statin use and risk for severe headache or migraine by serum vitamin D status: a cross-sectional population-based study.

作者信息

Buettner Catherine, Burstein Rami

机构信息

Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, USA Harvard Medical School, USA

Harvard Medical School, USA Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, USA.

出版信息

Cephalalgia. 2015 Aug;35(9):757-66. doi: 10.1177/0333102414559733. Epub 2014 Nov 25.

DOI:10.1177/0333102414559733

PMID:25424706

Abstract

OBJECTIVE

The objective of this article is to evaluate whether statin use and vitamin D status is associated with severe headache or migraine in a nationally representative sample.

METHODS

We conducted a cross-sectional study of US individuals aged ≥40 years for whom information on statin use, serum 25-hydroxy vitamin D (25(OH)D), and self-reported severe headache or migraine had been collected. We calculated prevalence estimates of headache according to statin and 25(OH)D, and conducted adjusted logistic regression analyses stratified by the median 25(OH)D (≤57 and >57 nmol/l).

RESULTS

Among 5938 participants, multivariable-adjusted logistic regression showed that statin use was significantly associated with a lower prevalence of severe headache or migraine (OR 0.67; 95% CI 0.46, 0.98, p = 0.04). We found a significant interaction between statin use and 25(OH)D with the prevalence of severe headache or migraine (p for interaction = 0.005). Among participants who had serum 25(OH)D > 57 nmol/l, statin use was associated with a multivariable-adjusted odds ratio of 0.48 (95% CI 0.32, 0.71, p = 0.001) for having severe headache or migraine. Among those with 25(OH)D ≤ 57 nmol/l, no significant association was observed between statin use and severe headache or migraine.

CONCLUSION

Statin use in those with higher serum vitamin D levels is significantly associated with lower odds of having severe headache or migraine.

摘要

目的

本文旨在评估在一个具有全国代表性的样本中，他汀类药物的使用和维生素D状态是否与严重头痛或偏头痛相关。

方法

我们对年龄≥40岁的美国个体进行了一项横断面研究，这些个体已收集了他汀类药物使用、血清25-羟基维生素D（25(OH)D）以及自我报告的严重头痛或偏头痛的信息。我们根据他汀类药物使用情况和25(OH)D水平计算头痛的患病率估计值，并按25(OH)D中位数（≤57和>57 nmol/L）进行分层调整的逻辑回归分析。

结果

在5938名参与者中，多变量调整后的逻辑回归显示，使用他汀类药物与严重头痛或偏头痛的较低患病率显著相关（比值比0.67；95%置信区间0.46，0.98，p = 0.04）。我们发现他汀类药物使用与25(OH)D之间在严重头痛或偏头痛患病率方面存在显著交互作用（交互作用p值 = 0.005）。在血清25(OH)D > 57 nmol/L的参与者中，使用他汀类药物与严重头痛或偏头痛的多变量调整后比值比为0.48（95%置信区间0.32，0.71，p = 0.001）。在25(OH)D≤57 nmol/L的参与者中，未观察到他汀类药物使用与严重头痛或偏头痛之间存在显著关联。