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Serum Vitamin B12 and Methylmalonic Acid Status in Migraineurs: A Case-Control Study
Mansoureh Togha1, Soodeh Razeghi Jahromi2, Zeinab Ghorbani3
1Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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.
Insights
Lower vitamin B12 and higher methylmalonic acid (MMA) levels are linked to increased migraine risk. This suggests vitamin B12 deficiency may play a role in migraine pathogenesis.
Area of Science:
- Neurology
- Biochemistry
- Nutritional Science
Background:
- Migraine pathophysiology involves complex mechanisms like neurogenic inflammation and trigeminovascular activation.
- Proposed pathways include nitric oxide (NO) and homocysteine (Hcy) dysregulation.
- Vitamin B12 is implicated in NO scavenging and preventing hyperhomocysteinemia, suggesting a role in migraine.
Purpose of the Study:
- To investigate serum vitamin B12 and methylmalonic acid (MMA) levels in migraine patients compared to healthy controls.
- To evaluate the association between vitamin B12 status and migraine prevalence.
- To assess the relationship between MMA levels and migraine risk.
Main Methods:
- A case-control study involving 70 migraine patients and 70 healthy controls.
- Serum vitamin B12 and MMA levels were quantified using enzyme-linked immunosorbent assay (ELISA).
- Demographic data and migraine characteristics (headache frequency, severity, duration) were collected.
Main Results:
- Migraine patients exhibited significantly lower serum vitamin B12 levels (512 ± 300 pg/mL) compared to controls (667 ± 351 pg/mL).
- Migraineurs showed significantly higher serum MMA levels (1.39 [0.59,4.01] µg/dL) than controls (1.01 [0.49,1.45] µg/dL).
- Higher vitamin B12 quartiles correlated with decreased migraine odds (OR=0.20), while higher MMA quartiles correlated with increased migraine odds (OR=5.44).
Conclusions:
- Reduced serum vitamin B12 and elevated MMA levels are associated with a higher likelihood of experiencing migraines.
- These findings suggest that suboptimal vitamin B12 status, indicated by lower B12 and higher MMA, may contribute to migraine development.
- No association was found between vitamin B12 or MMA levels and specific headache characteristics.
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