ASSOCIATION OF VITAMIN D AND ZINC WITH INFLAMMATORY MARKERS AND OXIDATIVE STRESS IN MIGRAINE PATIENTS

Abstract

Migraine is the most common neurological condition seen in primary care. Globally its affects 2% of population (out of which 1.5% are female and 0.5% are male). Migraine is an episodic and complex sensory processing disorder characterized by a range of symptoms, with headache being the hallmark feature, typically localized to one side of the head. Numerous studies have investigated the role of biochemical parameters in migraines to establish a clear cause-and-effect relationship. This study is an attempt to contribute towards studies that are trying to establish exact cause for prevalence of migraine. The objectives of the study were to compare the biochemical parameters such as Vitamin D, Zinc, IL-10, IFN Gamma, CRP, SOD & MDA. This was a case control study and ethical approval was taken from Bahria University Health Sciences Karachi (BUHSCK). Migraine patients between age 20-40 years were included in cases and healthy participants were included in controls. The calculated sample size of 246 subjects were divided into two groups, out which 123 were cases and 123 were controls. Venous blood sample was taken for measuring different parameters like Vitamin D, Zinc, IL-10, IFN- Gamma, CRP, SOD & MDA. The obtained results were statistically analyzed by SPSS version 23. Descriptive statistics were presented in terms of frequency with percentages and mean with standard deviation and Median with Interquartile range (IQR). Independent sample t-test was used to compare the mean of baseline characteristics of controls and migraine patients. Mann Whitney U test was used to compare the median of skewed and not normally distributed parameters between two study groups. Pearson Correlation was used to check the relationship. Binary Logistic regression analysis was used to estimate the risk estimation of migraine. P-values less than 0.05 were considered statistically significant. The mean comparison of baseline characteristics between controls and migraine patients, in control group mean Age (years) was 33.6±4.7, mean BMI (kg/m2) was 27.7±5.1, mean SBP was 122.2±9, mean DBP was 81.8±4.4, mean Temperature was 98.1±0.2, whereas in migraine patients mean Age (years) was33.2±4.6, mean BMI (kg/m2) was 28.4±4.8, mean SBP was 121.5±10, mean DBP was 81.9±4.7, mean Temperature was 98±0.1, Independent sample t-test showed significant mean difference in temperature between controls and migraine patients (p=0.027), all other viii characteristics were found statistically insignificant (p>0.05). The comparison results of Vitamin D, Zinc, SOD and MDA between controls and migraine patients, showed in control group samples median for Vitamin D (ng/ml) was 14(IQR=7), median for Zinc (μg/dL) was 88(IQR=11), median for SOD (nm/ml) was 41(IQR=29), and median for MDA (U/mL) was 2(IQR=1), whereas in migraine patients median for Vitamin D (ng/ml) was 20(IQR=15), median for Zinc (μg/dL) was 65(IQR=7) median for SOD (nm/ml) was 10(IQR=4), and median for MDA (U/mL) was 4(IQR=1). Mann Whitney U test gave significant difference in the median of vitamin D, Zinc, SOD, and MDA between controls and migraine patients (p<0.01). The comparison of CRP, IL-10 and IFN Gamma between control and migraine patients, results showed among controls median for CRP level (mg/dL) was 1(IQR=2), median for IL-10 level (pgm/ml) was 301(IQR=1313), and median for IFN gamma (ngm/ml) was 141(IQR=203), whereas in migraine patients median for CRP level (mg/dL) was 2(IQR=4), median for IL-10 level (pgm/ml) was 243(IQR=114), and median for IFN gamma (ngm/ml) was 63(IQR=108). Mann Whitney U test gave significant difference in the CRP levels, IL-10 and IFN gamma between controls and Migraine with p<0.05. Our study concludes that migraine patients exhibit deficiencies in vitamin D and zinc, accompanied by reduced superoxide dismutase (SOD) levels and elevated malondialdehyde (MDA), indicating a role for oxidative stress in migraine pathogenesis. Increased CRP levels, along with reduced IFN-gamma and IL-10, point to a complex inflammatory response. The relationship between these biomarkers suggests that vitamin D and zinc deficiencies may exacerbate oxidative stress and inflammation, leading to neuronal damage and enhanced vasodilation, thus contributing to migraine development. These novel insights will aid healthcare professionals in refining the management approaches, allowing for targeted treatments that address underlying nutritional deficiencies, oxidative stress, and inflammation in migraine patients