TY - JOUR
T1 - Associations between Migraine and Type 2 Diabetes in Women
T2 - Findings from the E3N Cohort Study
AU - Fagherazzi, Guy
AU - El Fatouhi, Douae
AU - Fournier, Agnès
AU - Gusto, Gaelle
AU - Mancini, Francesca Romana
AU - Balkau, Beverley
AU - Boutron-Ruault, Marie Christine
AU - Kurth, Tobias
AU - Bonnet, Fabrice
N1 - Funding Information:
Author Contributions: Dr Fagherazzi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Fagherazzi, El Fatouhi, Kurth, Bonnet. Acquisition, analysis, or interpretation of data: Fagherazzi, El Fatouhi, Fournier, Gusto, Mancini, Balkau, Boutron-Ruault. Drafting of the manuscript: Fagherazzi, El Fatouhi, Bonnet. Critical revision of the manuscript for important intellectual content: Fagherazzi, Fournier, Gusto, Mancini, Balkau, Boutron-Ruault, Kurth. Statistical analysis: Fagherazzi, El Fatouhi, Gusto, Balkau, Kurth. Obtained funding: Fagherazzi. Administrative, technical, or material support: El Fatouhi. Supervision: Boutron-Ruault, Bonnet. Other: Mancini. Conflict of Interest Disclosures: Dr Kurth reports having contributed to an advisory board of CoLucid and a research project funded by Amgen, for which the Charité–Universitätmedizin Berlin received compensation; having received honoraria from Lilly for providing methodological advice, from Novartis and Daiichi Sankyo for providing a lectures on epidemiologic methods, and from BMJ for editorial services; and having received travel support from the International Headache Society for being a member of the board of trustees. No other disclosures were reported. Funding/Support: The E3N cohort is carried out with the financial support of the “Mutuelle Générale de l'Education Nationale,” European Community, French League against Cancer, Gustave Roussy, and French Institute of Health and Medical Research. This present study was also supported by the French Research Agency (Agence Nationale de la Recherche) via an “Investissement d’Avenir” grant (ANR-10-COHO-0006) that supports the associated E4N study. Role of the Funder/Sponsor: The funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Additional Contributions: We thank all participants for providing the data used in the E3N cohort study.
Publisher Copyright:
© 2018 American Medical Association. All rights reserved.
PY - 2019/3
Y1 - 2019/3
N2 - Importance: Little is known about the associations between migraine and type 2 diabetes and the temporality of the association between these 2 diseases. Objective: To evaluate the association between migraine and type 2 diabetes incidence as well as the evolution of the prevalence of active migraine before and after type 2 diabetes diagnosis. Design, Setting, and Participants: We used data from the E3N cohort study, a French prospective population-based study initiated in 1990 on a cohort of women born between 1925 and 1950. The E3N study participants are insured by a health insurance plan that mostly covers teachers. From the eligible women in the E3N study, we included those who completed the 2002 follow-up questionnaire with information available on migraine. We then excluded prevalent cases of type 2 diabetes, leaving a final sample of women who were followed up between 2004 and 2014. All potential occurrences of type 2 diabetes were identified through a drug reimbursement database. Statistical analyses were performed in March 2018. Exposures: Self-reported migraine occurrence. Main Outcomes and Measures: Pharmacologically treated type 2 diabetes. Results: From the 98995 women in the study, 76403 women completed the 2002 follow-up survey. Of these, 2156 were excluded because they had type 2 diabetes, leaving 74247 women. Participants had a mean (SD) age of 61 (6) years at baseline, and all were free of type 2 diabetes. During 10 years of follow-up, 2372 incident type 2 diabetes cases occurred. A lower risk of type 2 diabetes was observed for women with active migraine compared with women with no migraine history (univariate hazard ratio, 0.80 [95% CI, 0.67-0.96], multivariable-adjusted hazard ratio, 0.70 [95% CI, 0.58-0.85]). We also observed a linear decrease in active migraine prevalence from 22% (95% CI, 16%-27%) to 11% (95% CI, 10%-12%) during the 24 years prior to diabetes diagnosis, after adjustment for potential type 2 diabetes risk factors. A plateau of migraine prevalence around 11% was then observed for 22 years after diagnosis. Conclusions and Relevance: We observed a lower risk of developing type 2 diabetes for women with active migraine and a decrease in active migraine prevalence prior to diabetes diagnosis. Further targeted research should focus on understanding the mechanisms involved in explaining these findings..
AB - Importance: Little is known about the associations between migraine and type 2 diabetes and the temporality of the association between these 2 diseases. Objective: To evaluate the association between migraine and type 2 diabetes incidence as well as the evolution of the prevalence of active migraine before and after type 2 diabetes diagnosis. Design, Setting, and Participants: We used data from the E3N cohort study, a French prospective population-based study initiated in 1990 on a cohort of women born between 1925 and 1950. The E3N study participants are insured by a health insurance plan that mostly covers teachers. From the eligible women in the E3N study, we included those who completed the 2002 follow-up questionnaire with information available on migraine. We then excluded prevalent cases of type 2 diabetes, leaving a final sample of women who were followed up between 2004 and 2014. All potential occurrences of type 2 diabetes were identified through a drug reimbursement database. Statistical analyses were performed in March 2018. Exposures: Self-reported migraine occurrence. Main Outcomes and Measures: Pharmacologically treated type 2 diabetes. Results: From the 98995 women in the study, 76403 women completed the 2002 follow-up survey. Of these, 2156 were excluded because they had type 2 diabetes, leaving 74247 women. Participants had a mean (SD) age of 61 (6) years at baseline, and all were free of type 2 diabetes. During 10 years of follow-up, 2372 incident type 2 diabetes cases occurred. A lower risk of type 2 diabetes was observed for women with active migraine compared with women with no migraine history (univariate hazard ratio, 0.80 [95% CI, 0.67-0.96], multivariable-adjusted hazard ratio, 0.70 [95% CI, 0.58-0.85]). We also observed a linear decrease in active migraine prevalence from 22% (95% CI, 16%-27%) to 11% (95% CI, 10%-12%) during the 24 years prior to diabetes diagnosis, after adjustment for potential type 2 diabetes risk factors. A plateau of migraine prevalence around 11% was then observed for 22 years after diagnosis. Conclusions and Relevance: We observed a lower risk of developing type 2 diabetes for women with active migraine and a decrease in active migraine prevalence prior to diabetes diagnosis. Further targeted research should focus on understanding the mechanisms involved in explaining these findings..
UR - http://www.scopus.com/inward/record.url?scp=85058564385&partnerID=8YFLogxK
U2 - 10.1001/jamaneurol.2018.3960
DO - 10.1001/jamaneurol.2018.3960
M3 - Article
C2 - 30556831
AN - SCOPUS:85058564385
SN - 2168-6149
VL - 76
SP - 257
EP - 263
JO - JAMA Neurology
JF - JAMA Neurology
IS - 3
ER -