Oligomerization state-dependent elevations of adiponectin in chronic daily headache

Objective: To evaluate serum adiponectin levels in female episodic migraineurs (EMs) and chronic daily headache (CDH) sufferers. Background: Obesity is a risk factor for headache chronification. Adiponectin (ADP) is an adipocytokine secreted primarily by adipose tissue. ADP and its oligomers (high-molecular-weight [HMW], middle-molecular-weight [MMW], and low-molecular-weight [LMW] ADP) have been shown to modulate several inflammatory pathways that have also been shown to be associated with migraine pathophysiology. Methods: Age- and body mass index (BMI)-matched women participants were enrolled. Anthropometric measures (including waist-to-hip ratio [WHR] and BMI) were measured in all participants. Serum total ADP (T-ADP) levels and its oligomers were measured in EMs during headache-free periods and CDH sufferers at baseline level of pain, as compared with healthy control subjects using ELISA. Results: Although total body obesity as estimated by BMI showed no significant association between participants, visceral obesity as estimated by WHR was significantly associated with CDH as compared with EMs and controls. WHR was also inversely related to both T-ADP (p = 0.008) and HMW-ADP (p = 0.002). After adjusting for WHR, serum T-ADP levels were higher in CDH sufferers (10.1 +/- 4.0) than in both EMs (8.6 +/- 3.5) and controls (7.5 +/- 2.4) (p = 0.024). In addition, HMW-ADP was higher in CDH (6.1 +/- 2.8) as compared with EMs (4.2 +/- 1.7) and controls (3.9 +/- 1.5) (p = 0.003). MMW-ADP was also higher in CDH (2.0 +/- 1.2) as compared with EMs (1.5 +/- 0.7) and controls (1.1 +/- 0.4) (p = 0.009). Conclusion: Serum adiponectin levels are increased in women chronic daily headache (CDH) sufferers. In addition, visceral obesity, as measured by waist-to-hip ratio, is a risk factor for CDH in women.