Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus

Abstract

Migraine is a disabling neurovascular disorder, characterized by moderate to severe unilateral headaches, nausea, photophobia, and/or phonophobia, with a higher prevalence in women than in men, which can drastically affect the quality of life of migraine patients. In addition, this chronic disorder is related with metabolic comorbidities associated with the patient's lifestyle, including obesity and diabetes mellitus (DM). Beyond the personal and socioeconomic impact caused by migraine, obesity and DM, it has been suggested that these metabolic disorders seem to be related to migraine since: (i) they are a risk factor for developing cardiovascular disorders or chronic diseases; (ii) they can be influenced by genetic and environmental risk factors; and (iii) while clinical and epidemiological studies suggest that obesity is a risk factor for migraine, DM (i.e., type 1 and type 2 DM) have been reported to be either a protective or a risk factor in migraine. On this basis, and given the high worldwide prevalence of migraine, obesity, and DM, this article provides a narrative review of the current literature related to the association between the etiology and pathophysiology of migraine and these metabolic disorders, considering lifestyle aspects, as well as the possible involvement of neurotransmitters, neuropeptides, and/or sex hormones. While a link between migraine and metabolic disorders has been suggested, many studies are contradictory and the mechanisms involved in this association are not yet sufficiently established. Therefore, further research should be focused on understanding the possible mechanisms involved.

Keywords: CGRP; comorbidities; diabetes mellitus; lifestyle; metabolic disorders; migraine; obesity.

Figure 1

Common factors between migraine, obesity and diabetes mellitus. Environmental, genetic, and lifestyle factors are involved in the etiology of migraine, obesity, and DM. In addition, the role of pro-inflammatory markers, neuropeptides, adipokines, sex hormones, and/or monoamines in the onset, development and progression of the disease, may indicate a possible link between these disorders. Created with BioRender.com.

Figure 2

Possible mechanisms involved in the association between migraine, obesity, and diabetes mellitus. Lifestyle habits can modify the activity of the central and peripheral nervous systems. The influence of the central nervous system via the activation of hypothalamus and the sympathetic autonomic dysfunction during migraine attacks, obesity, and DM might be potential mechanisms to describe the relationship between migraine and these metabolic disorders. Created with BioRender.com.