Angela Ruban, Andrea L C Schneider, Menglu Liang, Rebecca F Gottesman, Elizabeth Selvin, Josef Coresh, Mariana Lazo, Silvia Koton
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Increases in glutamate levels in the brain and plasma of migraine patients have been reported, but less is known about the association between liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (GGT) that regulate blood glutamate levels and migraine.</p><p><strong>Objectives: </strong>We evaluated associations between AST, ALT, and GGT levels across the quartiles and a history of probable/defined migraine in the Atherosclerosis Risk in Communities Study cohort.</p><p><strong>Design: </strong>We included 11,718 participants with measured liver enzyme levels and self-reported data on migraine with and without aura. Multiple logistic regression models were used to assess associations of sex-specific quartiles of liver enzymes with probable/definite migraine.</p><p><strong>Results: </strong>A total of 1626 probable/definite migraine events were reported in 1993-1995. After adjustment for age, race-center, and sex, higher levels of AST, ALT, and GGT were associated with a lower prevalence of migraine. The adjusted odds ratios (95% CIs) for migraine for Q1 versus Q4 levels of AST, ALT, and GGT were 1.24 (1.06-1.45), 1.17 (1.00-1.37) and 1.21 (1.03-1.41), respectively. Analysis by yes/no aura showed higher odds of migraine without aura for lower (Q1) compared with higher (Q4) levels of ALT (adjusted OR 1.38, 95% CI 1.05-1.82), while no significant association was observed between enzyme levels and prevalence of migraine with aura.</p><p><strong>Conclusion: </strong>Our findings suggest that higher AST, ALT, and GGT levels are associated with a lower prevalence of migraine. Although the exact mechanisms linking lower blood levels of AST, ALT, and GGT to migraines remain unclear, their association may be explained by inefficient plasma glutamate regulation, which could play a role in migraine pathology. This finding is important for patients as it sheds light on potential metabolic contributions to migraines, supporting the hypothesis that factors beyond traditional neurovascular theories are involved.</p>","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251370097"},"PeriodicalIF":4.1000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433560/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between liver enzyme levels and prevalence of migraine: the atherosclerosis risk in communities study.\",\"authors\":\"Angela Ruban, Andrea L C Schneider, Menglu Liang, Rebecca F Gottesman, Elizabeth Selvin, Josef Coresh, Mariana Lazo, Silvia Koton\",\"doi\":\"10.1177/17562864251370097\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cumulative research data indicate that migraine is characterized by a glutamatergic imbalance, particularly an excessive glutamatergic signal. 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引用次数: 0
摘要
背景:累积的研究数据表明偏头痛的特点是谷氨酸能失衡,特别是谷氨酸能信号过度。偏头痛患者的大脑和血浆中谷氨酸水平升高已被报道,但对于肝酶,如调节血液谷氨酸水平和偏头痛的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和γ -谷氨酰转肽酶(GGT)之间的关系知之甚少。目的:我们评估社区动脉粥样硬化风险研究队列中AST、ALT和GGT水平与可能/明确偏头痛病史之间的关系。设计:我们纳入了11718名参与者,他们测量了肝酶水平,并自我报告了有或无先兆偏头痛的数据。多逻辑回归模型用于评估肝酶的性别特异性四分位数与可能/确定偏头痛的关系。结果:1993-1995年共报告了1626例疑似/确诊偏头痛事件。在调整了年龄、种族中心和性别后,较高水平的AST、ALT和GGT与较低的偏头痛患病率相关。偏头痛患者第一季度与第四季度AST、ALT和GGT水平的校正优势比(95% ci)分别为1.24(1.06-1.45)、1.17(1.00-1.37)和1.21(1.03-1.41)。有/无先兆分析显示,与高(Q4) ALT水平相比,低(Q1)无先兆偏头痛的几率更高(调整OR 1.38, 95% CI 1.05-1.82),而酶水平与有先兆偏头痛患病率之间没有显著关联。结论:我们的研究结果表明,较高的AST、ALT和GGT水平与较低的偏头痛患病率相关。虽然血液中谷氨酸转氨酶、谷氨酸转氨酶和谷氨酸转氨酶水平降低与偏头痛之间的确切联系机制尚不清楚,但它们之间的联系可能是由于血浆谷氨酸调节效率低下,这可能在偏头痛病理中起作用。这一发现对患者来说很重要,因为它揭示了代谢对偏头痛的潜在影响,支持了传统神经血管理论之外的因素参与的假设。
Association between liver enzyme levels and prevalence of migraine: the atherosclerosis risk in communities study.
Background: Cumulative research data indicate that migraine is characterized by a glutamatergic imbalance, particularly an excessive glutamatergic signal. Increases in glutamate levels in the brain and plasma of migraine patients have been reported, but less is known about the association between liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (GGT) that regulate blood glutamate levels and migraine.
Objectives: We evaluated associations between AST, ALT, and GGT levels across the quartiles and a history of probable/defined migraine in the Atherosclerosis Risk in Communities Study cohort.
Design: We included 11,718 participants with measured liver enzyme levels and self-reported data on migraine with and without aura. Multiple logistic regression models were used to assess associations of sex-specific quartiles of liver enzymes with probable/definite migraine.
Results: A total of 1626 probable/definite migraine events were reported in 1993-1995. After adjustment for age, race-center, and sex, higher levels of AST, ALT, and GGT were associated with a lower prevalence of migraine. The adjusted odds ratios (95% CIs) for migraine for Q1 versus Q4 levels of AST, ALT, and GGT were 1.24 (1.06-1.45), 1.17 (1.00-1.37) and 1.21 (1.03-1.41), respectively. Analysis by yes/no aura showed higher odds of migraine without aura for lower (Q1) compared with higher (Q4) levels of ALT (adjusted OR 1.38, 95% CI 1.05-1.82), while no significant association was observed between enzyme levels and prevalence of migraine with aura.
Conclusion: Our findings suggest that higher AST, ALT, and GGT levels are associated with a lower prevalence of migraine. Although the exact mechanisms linking lower blood levels of AST, ALT, and GGT to migraines remain unclear, their association may be explained by inefficient plasma glutamate regulation, which could play a role in migraine pathology. This finding is important for patients as it sheds light on potential metabolic contributions to migraines, supporting the hypothesis that factors beyond traditional neurovascular theories are involved.
期刊介绍:
Therapeutic Advances in Neurological Disorders is a peer-reviewed, open access journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of neurology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in neurology, providing a forum in print and online for publishing the highest quality articles in this area.