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转载 Migraine prevalence, socioeconomic status, and social causation

唐修明 主任医师 东莞市滨海湾中心医院 神经内科
2013-09-22 205人已读
唐修明 主任医师
东莞市滨海湾中心医院

Migraine prevalence, socioeconomic status, and social causation
1.Walter F. Stewart, PhD,
2.Jason Roy, PhD and
3.Richard B. Lipton, MD
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1.Correspondence to Dr. Stewart: stewarwf@sutterhealth.org
1.Published online before print August 29, 2013, doi: 10.1212/WNL.0b013e3182a43b32Neurology 10.1212/WNL.0b013e3182a43b32东莞市滨海湾中心医院神经内科唐修明
 
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ABSTRACT
Objective: To determine whether the known higher prevalence of migraine in lower household (HH) income groups is explained by a higher incidence rate or a lower remission rate.

Methods: We used data from the American Migraine Prevalence and Prevention Study, a US national sample of 132,674 females (with a 64.3% response rate) and 124,665 males (with a 62.0% response rate) 12 years of age and older. Data were previously collected on migraine symptoms, onset age, and demographics. Previously validated methods applied to the American Migraine Prevalence and Prevention Study data were used to simulate a cohort study. Incidence and remission rates were estimated within 3 sex-specific HH income groups (<$22,500, $22,500–$59,999, and ≥$60,000). The χ2 test was used to determine whether the incidence or remission rates differed by HH income group as an explanation for differences in migraine prevalence by HH income.

Results: Migraine prevalence increased as HH income decreased for females (χ2, p < 0.01) and males (χ2, p < 0.01). Differences were not explained by race and other known confounders. Variation in prevalence was explained, in large part, by a higher incidence rate in the lower HH income groups for both females (χ2, p < 0.01) and males (χ2, p < 0.01). Migraine remission rates did not differ by HH income.

Conclusions: The higher incidence of migraine in lower HH income groups is compatible with the social causation hypothesis. Once initiated, migraine remission is independent of HH income. Onset and remission may have etiologically distinct causes.

•Received November 13, 2012.
•Accepted in final form May 21, 2013.

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唐修明 主任医师

东莞市滨海湾中心医院 神经内科

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