Impaired bone status in high frequency episodic or chronic migraine women: A case-control study with blood and densitometric parameters
Marina Haro, María Muñoz-San Martín, Gabriel Gárate, Lucia De La Guerra, Vicente González-Quintanilla, Jorge Madera, Sara Pérez-Pereda, Carmen Valero, José Manuel Olmos, José Luis Hernández, Julio PascualBackground/Aim
Migraine and osteoporosis are highly prevalent in women and represent a substantial socio-health burden. We aimed to comprehensively assess bone status in women with frequent migraine.
Patients and Methods
Adult women with high-frequency episodic migraine (HFEM) or chronic migraine (CM) were recruited and compared with age- and body mass index–matched female controls. Serum parameters of bone metabolism, including 25-hydroxyvitamin D (25[OH]D), calcium and parathyroid hormone (PTH), as well as bone turnover markers (procollagen type 1 N-terminal propeptide [P1NP] and C-terminal telopeptide of type I collagen [CTX]), were measured. Bone mineral density (BMD), T-scores and trabecular bone score (TBS) were assessed by dual-energy X-ray absorptiometry.
Results
A total of 108 women with CM/HFEM and 129 matched controls were included. Compared with controls, women with migraine had lower serum 25(OH)D and calcium levels (p ≤ 0.001) and higher adjusted CTX levels (p = 0.039). Densitometric assessment revealed significantly reduction in BMD at femoral neck (g/cm 2 and T-score) and total hip (T-score) in the migraine group (p < 0.001). Lumbar TBS was also lower in CM/HFEM patients (p < 0.001). After multivariable adjustment, TBS remained independently associated with migraine status. These alterations remained in women with HFEM and in those younger than 50 years, and were associated with reduced physical activity and sun exposure.
Conclusions
Women with frequent migraine exhibit impaired bone health, characterized by alterations in bone mass and trabecular microarchitecture. TBS appears to be a sensitive marker of early skeletal involvement in this population. The presence of bone impairment in HFEM and in premenopausal women supports early assessment of bone status and reinforcement of lifestyle interventions, including adequate physical activity and sun exposure.