Serum Vitamin B12 and Methylmalonic Acid Status in Migraineurs: A Case-Control Study.
BACKGROUND
Although the exact pathophysiological mechanistic pathways that result in the initiation of migraine attacks remain unclear, there are some proposed mechanisms including neurogenic inflammation, trigeminovascular system activation, vascular dysfunction, and augmented release of nitric oxide (NO) and homocysteine (Hcy). Vitamin B12 is thought to be involved in important pathways that seem to be related to the pathogenesis of migraine including scavenging against NO and prevention of hyperhomocysteinemia. Therefore, the aim of the current study was to evaluate the serum vitamin B12 and methylmalonic acid (MMA) status in a group of migraine patients compared to healthy controls.


METHODS
After the recruitment of cases and controls, demographic data and migraine characteristics (including the number of headache days, severity of headaches, and duration of each attack in hours) were recorded. Serum vitamin B12 and MMA levels were measured using the enzyme-linked immunosorbent assay technique.


RESULTS
Seventy migraine patients and 70 healthy subjects were enrolled in this case control study. The serum levels of B12 were found to be significantly lower in migraine patients than in healthy subjects (512 ± 300 vs 667 ± 351 pg/mL, P = .007); whereas migraineurs had higher levels of MMA than controls (1.39 [0.59,4.01] vs 1.01 [0.49,1.45] µg/dL, P = .027). In the fully adjusted multiple regression model, those in the highest vs the lowest serum B12 quartile had 80% decrease in the odds of having migraine ([OR = 0.20, 95% CI = 0.05-0.73], [P for trend = .008]); while, patients in the highest quartile of MMA had more than 5 times increased risk of having migraine ([OR = 5.44, 95% CI = 1.49-19.87] [P for trend = .002]). There was no association between serum B12 and MMA levels and headache characteristics.


CONCLUSION
Taken together, these findings suggest that participants with lower vitamin B12 and higher MMA levels that considered as lower functional activity of B12 had higher odds of migraine.
['Togha|Mansoureh|M|0000-0002-9368-6835', 'Razeghi Jahromi|Soodeh|S|', 'Ghorbani|Zeinab|Z|', 'Martami|Fahimeh|F|', 'Seifishahpar|Maryam|M|']
D000293:Adolescent D000328:Adult D000886:Anthropometry D016022:Case-Control Studies D017281:Cost of Illness D018450:Disease Progression D005260:Female D006710:Homocysteine D006801:Humans D008297:Male D008764:Methylmalonic Acid D008875:Middle Aged D008881:Migraine Disorders D009752:Nutritional Status D010147:Pain Measurement D012923:Social Class D014805:Vitamin B 12 D055815:Young Adult
vitamin B12 methylmalonic acid migraine hyperhomocysteinemia