Elevado gasto energético de repouso em mulheres com migrânea episódica: o uso de fórmulas preditivas

Abstract

Migraine is a common and disabling primary headache and its pathophysiology is not fully understood. The most common hypothesis for the migraine attacks development is the activation of trigeminal afferent fibers, leading to a state of neurogenic inflammation. Previous studies suggest the effect of pain on energy expenditure in humans. The investigation of the energy expenditure of patients with migraine is relevant to provide an adequate dietary intervention to the patients. The objective of this study is to assess whether the resting energy expenditure of women with migraine differs from that of women without migraine. This is a cross-sectional study involving adult women aged between 18 and 65 years with or without (controls) migraine. This study took place at the Headache Outpatient Clinic of Hospital das Clínicas, Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). We collected clinical and demographic data using a semi-structured questionnaire. Migraine severity was measured using the Migraine Disability Test and Headache Impact Test, version 6. Body weight and height were measured. Body composition was evaluated by electric bioimpedance. Resting energy expenditure was measured by Indirect Calorimetry and compared with the predicted resting energy expenditure calculated using predictive formulas, selected by frequency of use and clinical relevance. Blood samples were collected of a subsample after an overnight fasting. Patients with migraine had higher resting energy expenditure when compared to controls (P<0.01). Moreover, the resting energy expenditure positively correlated with the number of migraine attacks (Rho=0.226; P=0.044). Patients with migraine had higher serum levels of adiponectin, however, it did not correlate with the resting energy expenditure (Rho=0.140, P=0.343). There was no difference in serum leptin levels between the groups (P=0.968). Regarding the predictive formulas, we observed that Mifflin-St Jeor and Henry and Rees were those that have more accuracy to predict resting energy expenditure in women with migraine. The findings of this study suggest that patients with migraine have higher resting energy expenditure when compared to individuals without migraine, and it can be correlated with the number of migraine attacks. The Mifflin-St. Jeor and Henry and Rees formulas are the most accurate to predict resting energy expenditure in women with migraine. In addition, this study also suggests that adiponectin play a role in the pathophysiology of migraine.