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. 2024 Dec 5;20(1):71.
doi: 10.1186/s13005-024-00475-5.

Gender-specific inflammatory burden and headache risk in youth: a NHANES analysis

Binbin Zhu  1   2   3 , Rui Zhao  4   5 , Long Wang  6 , Changshun Huang  7 , Yiwei Zhang  4 , Zhiyou Peng  8 , Yijun Chen  9
Affiliations

Gender-specific inflammatory burden and headache risk in youth: a NHANES analysis

Binbin Zhu et al. Head Face Med. .

Abstract

Background: Headaches are a common and often debilitating condition among youth. The Inflammatory Burden Index (IBI), a simple surrogate marker of systemic inflammation, has been linked to various diseases. However, evidence for its relationship with headaches, particularly in youth, is lacking. This study aimed to investigate the association between IBI and persistent headache in youth, with a focus on evaluating gender-specific responses to IBI exposure.

Methods: We analyzed data from 2,210 young people in the 2001-2004 National Health and Nutrition Examination Survey (NHANES). The association between IBI and frequent or severe headaches in the past year was investigated using weighted logistic regression models. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated, and threshold effect analyses were performed.

Results: Youths in the highest IBI quartile (Q4) had a 46% higher risk of severe headaches compared to the lowest quartile (Q1) (OR: 1.46, 95% CI: 1.12-1.91, P = 0.0051). Gender-stratified analysis revealed a significant association between high IBI and headache risk in females (OR: 1.48; 95% CI: 1.03-2.11, P = 0.0324), but not in males. Threshold effect analysis identified an IBI breakpoint of 3.78, below which the headache risk increased significantly in females under 18 years (OR: 1.12, 95% CI: 1.01-1.25, P = 0.0385).

Conclusions: Our findings demonstrate a significant association between elevated IBI and increased headache risk in youth, particularly in females. This gender-specific effect suggests that inflammatory processes may play a more prominent role in headache pathophysiology among female youth. These results underscore the importance of considering inflammatory markers in the early identification and prevention of youth headaches, especially in females.

Keywords: Gender differences; Headache; Inflammatory burden index; NHANES; Youth.

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Conflict of interest statement

Declarations. Ethical approval: This study utilized publicly available data from the National Health and Nutrition Examination Survey (NHANES), which is conducted by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). The NHANES protocol was approved by the NCHS Research Ethics Review Board (ERB), and all participants provided informed consent before data collection. For participants under 18 years of age, parental permission was obtained, and child assent was collected when appropriate. As our study involved secondary analysis of de-identified, publicly available data, it was exempt from additional institutional review board approval. We adhered to the ethical guidelines for the use of NHANES data as outlined by the NCHS, including proper citation and acknowledgment of the data source. All analyses were conducted in compliance with the NHANES data use agreement, ensuring participant confidentiality and data integrity. Consent for publication: The present study utilized data from the National Health and Nutrition Examination Survey (NHANES), which is publicly available and de-identified. As per NHANES guidelines, all participants provided informed consent for their data to be used in research and subsequent publications. No additional consent was required for this specific analysis and publication, as the data were already anonymized and intended for public use in research. The authors affirm that this manuscript is an honest, accurate, and transparent account of the study being reported, and that no important aspects of the study have been omitted. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study participants
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