Lipoprotein (a) [Lp(a)]: a possible link between migraine and stroke

Abstract

The biologic links by which migraine may be associated with vascular events are complex, and their exact mechanisms are currently unknown. Lipoprotein(a) [Lp(a)] has been suggested to be a risk factor for stroke, but no data are available concerning its role in migraine. The purpose of this study was to examine the role of Lp(a) in influencing migraine. Plasma levels of Lp(a) have been determined in 138 patients and in 120 control subjects comparable for age and sex. Abnormal Lp(a) levels, which are defined as more than 300 mg/L, significantly influenced the predisposition to migraine after adjustment for age, sex, and vascular traditional risk factors (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.57-7.55; P = 0.002). By analyzing Lp(a) concentrations according to sex, we observed a significant difference in Lp(a) 300 mg/L cutoff value between patients and controls in the female (P = 0.002) but not in the male group. Abnormal Lp(a) levels were significantly associated with migraine at multivariate analysis after adjustment for age, hypertension, and smoking habit in the female (OR, 3.88; 95% CI, 1.59-9.51; P = 0.003) but not in the male group. In all, 24 of 141 patients (17%) and 17 of 112 controls (15.2%) were postmenopausal women. By analyzing abnormal Lp(a) concentrations, no significant difference between premenopausal and postmenopausal women in both the patient and the control group was found (P = 0.4 and P = 0.6, respectively). No difference in Lp(a) concentrations was observed between patients with and without aura, and in relation to headache intensity. The current study suggested evidence of high Lp(a) concentrations affecting migraines, possibly hypothesizing a novel link between migraine and stroke.