B0640 - Migraine Disorder Occurs More Often in Celiac Disease Patients: A Nationwide Population-Based Cohort Study

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

AF

Andrew Ford, MD

Cleveland Clinic Foundation
Cleveland, OH

Andrew Ford, MD¹, Manik Aggarwal, MD¹, Motasem Alkhayyat, MD¹, Almaza A. Albakri, MD², Abel Joseph, MD¹, Claire Jansson-Knodell, MD¹, Alberto Rubio Tapia, MD³
¹Cleveland Clinic Foundation, Cleveland, OH; ²Royal Jordanian Medical Services, Amman, Al Karak, Jordan; ³Cleveland Clinic, Cleveland, OH

Introduction: Migraine disorder is a relatively common condition affecting nearly 15 percent of the general population. This disorder has been linked to multiple gastrointestinal diseases including celiac disease (CD), an autoimmune enteropathy characterized by immune-mediated damage resulting from gluten exposure. We aimed to further characterize the risk and epidemiologic association between CD and migraine disorder with this study.

Methods: We queried a multi-institutional database (Explorys Inc., Cleveland, OH); an aggregate of electronic health record data from 26 major US health systems. We formed cohorts of patients with CD and migraine disorder using Systemized Nomenclature of Medicine – Clinical Terms (SNOMED – CT). Migraine disorder was defined as SNOMED terms for “Migraine disorder” with prescribed migraine treatment (drug class: “migraine treatment”). Patients with diagnoses of cluster or tension headaches were excluded. Univariate and multivariate analyses were performed on the data, and associations were reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using IBM SPSS Statistics version 25.

Results: Of 30,142,740 adult patients in the database between 2017-2022, 91,390 (0.30%) carried a celiac disease diagnosis. Among celiac disease patients, 6,360 (6.9%) carried a migraine disorder diagnosis compared to 474,360 (1.6%) of the non-CD patients (p < 0.0001). After multivariate analysis, celiac disease was associated with an increased odds of migraine disorder (aOR = 1.49; 95% CI 1.42-1.57; p = < 0.0001) (Figure 1).

Discussion: This large population-based cohort study demonstrated significantly higher odds of migraine disorder among patients with celiac disease compared to patients without the disease. Our findings are in line with those from previous observational studies showing the same. Larger prospective studies would be beneficial in identifying the role of gluten exposure in this association

Figure: Risk factors for development of migraine disorder

Celiac Disease	With Migraine Disorder (n [%])	Without Migraine Disorder (n [%])	Multivariate Analysis (aOR [95% CI])*
Total	6360	85030	1.45 (1.42-1.57)

Risk factor
Alcohol use	240 (3.77)	1590 (1.87)	0.87 (0.84-0.89)
Obesity	2230 (35.1)	18230 (21.4)	1.43 (1.41-1.45)
Diabetes mellitus	390 (22.3)	17680 (20.8)	0.82 (0.81-0.83)
Male	560 (8.81)	18780 (22.1)	0.70 (0.69-0.70)
Smoker	720 (11.3)	5040 (5.93)	1.21 (1.19-1.23)
Caucasian	5720 (89.9)	56830 (66.8)	1.25 (1.24-1.27)
Senior (Age >65)	920 (14.5)	19550 (23.0)	0.61 (0.60-0.62)
Depression	3850 (60.5)	24840 (29.2)	1.71 (1.70-1.73)

Table: Prevalence of risk factors among celiac disease patients with respective adjusted odds ratios (aORs) by multivariate analysis; *p < 0.0001 for all aORs.

Disclosures:

Andrew Ford indicated no relevant financial relationships.

Manik Aggarwal indicated no relevant financial relationships.

Motasem Alkhayyat indicated no relevant financial relationships.

Almaza Albakri indicated no relevant financial relationships.

Abel Joseph indicated no relevant financial relationships.

Claire Jansson-Knodell: Clearpoint Neuro Inc – Stock-publicly held company(excluding mutual/index funds). Dariohealth Corp Com – Stock-publicly held company(excluding mutual/index funds). DermTech Inc – Stock-publicly held company(excluding mutual/index funds). DiaMedica Therapeutics Inc. – Stock-publicly held company(excluding mutual/index funds). Exact Sciences – Stock-publicly held company(excluding mutual/index funds). Inari – Stock-publicly held company(excluding mutual/index funds). Nano-X imaging ltd – Stock-publicly held company(excluding mutual/index funds). Outset medical – Stock-publicly held company(excluding mutual/index funds). PavMed – Stock-publicly held company(excluding mutual/index funds). Transmedics Group Inc – Stock-publicly held company(excluding mutual/index funds).

Alberto Rubio Tapia indicated no relevant financial relationships.

Andrew Ford, MD¹, Manik Aggarwal, MD¹, Motasem Alkhayyat, MD¹, Almaza A. Albakri, MD², Abel Joseph, MD¹, Claire Jansson-Knodell, MD¹, Alberto Rubio Tapia, MD³. B0640 - Migraine Disorder Occurs More Often in Celiac Disease Patients: A Nationwide Population-Based Cohort Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.