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Vitamin K2 Status and Arterial Stiffness Among Untreated Migraine Patients: A Case-Control Study.

  • 2019-11-25
  • Headache 60(3)
    • Anthony G Mansour
    • Rechdi Ahdab
    • Yazan Daaboul
    • Serge Korjian
    • Daniel Alexander Morrison
    • Essa Hariri
    • Maher Salem
    • Christelle El Khoury
    • Naji Riachi
    • Sola Aoun Bahous

Study Design

Type
Observational
Sample size
n = 146
Population
146 patients (73 matched pairs), of whom 89% were women with a mean age of 31.9 ± 8.4 years, including subjects with migraine and their age- and sex-matched controls
Methods
Case-control, single-center, observational study; arterial stiffness measured using carotid-femoral pulse wave velocity (cfPWV); dephosphorylated-uncarboxylated matrix-Gla-protein (dp-ucMGP) used as marker for vitamin K2 status; propensity-matched scoring method

Objective

We aimed to examine arterial stiffness and vitamin K2 status in migraine subjects by comparison to controls.

Background

Migraine is a primary headache disorder that has been associated with an increased risk of cardiovascular events. Mechanisms underlying this increased risk, however, remain unclear. Vitamin K2 deficiency emerged as a cardiovascular risk factor, but vitamin K2 status has never been explored in migraine subjects.

Design and methods

This is a case-control, single-center, observational study that includes a cohort of subjects with migraine and their age- and sex-matched controls. Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV). Dephosphorylated-uncarboxylated matrix-Gla-protein (dp-ucMGP) was used as a marker for vitamin K2 status. A propensity-matched scoring method was used.

Results

A total of 146 patients (73 matched pairs) were included in this study, of whom 89% were women with a mean age of 31.9 ± 8.4 years. Compared with controls, migraine patients had statistically significantly higher mean cfPWV (7.2 ± 1.1 vs 6.4 ± 0.8 m/s, 95% confidence interval (CI) of mean difference [0.45, 1.08], P < .001), as well as higher dp-ucMGP (454.3 ± 116.7 pmol/L vs 379.8 ± 126.6 pmol/L, 95% CI of mean difference [34.63, 114.31], P < .001). Higher cfPWV was associated with higher dp-ucMGP concentrations only in the migraine with aura (MWA) group. Moreover, migraine subjects had a higher frequency of vitamin K2 deficiency (dp-ucMGP ≥ 500 pmol/L) compared to controls, but this association was not statistically significant (23/73 [31.5%] vs 16/73 [21.9%], P = .193).

Conclusions

Individuals with migraine have worse indices of arterial stiffness as compared with their age- and sex-matched control subjects. This increase in arterial stiffness is associated with an increase in markers of vitamin K2 deficiency in the MWA group.

Research Insights

  • Vitamin K2→Reduced Arterial Stiffness

    Compared with controls, migraine patients had statistically significantly higher mean cfPWV (7.2 ± 1.1 vs 6.4 ± 0.8 m/s, 95% CI [0.45, 1.08], P < .001), as well as higher dp-ucMGP (454.3 ± 116.7 pmol/L vs 379.8 ± 126.6 pmol/L, 95% CI [34.63, 114.31], P < .001).

    Effect
    Neutral
    Effect size
    Small
  • Vitamin K2→Reduced Vitamin K2 Status

    Moreover, migraine subjects had a higher frequency of vitamin K2 deficiency (dp-ucMGP ≥ 500 pmol/L) compared to controls, but this association was not statistically significant (23/73 [31.5%] vs 16/73 [21.9%], P = .193).

    Effect
    Neutral
    Effect size
    Small
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