Background Migraine has many presumed comorbidities which have rarely been compared between samples with and without migraine. Examining the association between headache pain intensity and monthly headache day (MHD) frequency with migraine comorbidities is novel and adds to our understanding of migraine comorbidity. Methods The MAST Study is a prospective, web-based survey that identified US population samples of persons with migraine (using modified International Classification of Headache Disorders -3 beta criteria) and without migraine. Eligible migraine participants averaged ≥1 MHDs over the prior 3 months. Comorbidities “confirmed by a healthcare professional diagnosis” were endorsed by respondents from a list of 21 common cardiovascular, neurologic, psychiatric, sleep, respiratory, dermatologic, pain and medical comorbidities. Multivariable binary logistic regression calculated odds ratios (OR) and 95% confidence intervals for each condition between the two groups adjusting for sociodemographics. Modeling within the migraine cohort assessed rates of conditions as a function of headache pain intensity, MHD frequency, and their combination. Results Analyses included 15,133 people with migraine (73.0% women, 77.7% White, mean age 43 years) and 77,453 controls (46.4% women, 76.8% White, mean age 52 years). People with migraine were significantly ( P < 0.001) more likely to report insomnia (OR 3.79 [3.6, 4.0]), depression (OR 3.18 [3.0, 3.3]), anxiety (OR 3.18 [3.0 3.3]), gastric ulcers/GI bleeding (OR 3.11 [2.8, 3.5]), angina (OR 2.64 [2.4, 3.0]) and epilepsy (OR 2.33 [2.0, 2.8]), among other conditions. Increasing headache pain intensity was associated with comorbidities related to inflammation (psoriasis, allergy), psychiatric disorders (depression, anxiety) and sleep conditions (insomnia). Increasing MHD frequency was associated with increased risk for nearly all conditions and most prominent among those with comorbid gastric ulcers/GI bleeding, diabetes, anxiety, depression, insomnia, asthma and allergies/hay fever. Conclusions In regression models controlled for sociodemographic variables, all conditions studied were reported more often by those with migraine. Whether entered into the models separately or together, headache pain intensity and MHD frequency were associated with increased risk for many conditions. Future work is required to understand the causal sequence of relationships (direct causality, reverse causality, shared underlying predisposition), the potential confounding role of healthcare professional consultation and treatment, and potential detection bias.

中文翻译：

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偏头痛的共病和共病以及头痛强度和头痛频率增加的相关风险：美国偏头痛症状和治疗 (MAST) 研究的结果

背景 偏头痛有许多推测的合并症，很少在有和没有偏头痛的样本之间进行比较。检查头痛强度和每月头痛日 (MHD) 频率与偏头痛合并症之间的关联是新颖的，并增加了我们对偏头痛合并症的理解。方法 MAST 研究是一项基于网络的前瞻性调查，它确定了美国偏头痛患者（使用修正的国际头痛疾病分类 -3 beta 标准）和没有偏头痛的人群样本。符合条件的偏头痛参与者在前 3 个月内平均 ≥ 1 MHD。来自 21 种常见心血管疾病、神经系统疾病、精神疾病、睡眠疾病、呼吸系统疾病、皮肤疾病疾病、疼痛疾病和内科疾病的受访者认可了“由医疗保健专业人士诊断确认”的合并症。多变量二元逻辑回归计算了调整社会人口统计学的两组之间每种情况的优势比 (OR) 和 95% 置信区间。偏头痛队列中的建模评估了作为头痛疼痛强度、MHD 频率及其组合的函数的病症发生率。结果 分析包括 15,133 名偏头痛患者（73.0% 女性，77.7% 白人，平均年龄 43 岁）和 77,453 名对照组（46.4% 女性，76.8% 白人，平均年龄 52 岁）。偏头痛患者更容易报告失眠（OR 3.79 [3.6, 4.0]）、抑郁（OR 3.18 [3.0, 3.3]）、焦虑（OR 3.18 [3.0 3.3]）、胃溃疡/GI出血（OR 3.11 [2.8, 3.5]）、心绞痛（OR 2.64 [2.4, 3.0]）和癫痫（OR 2.33 [2.0, 2.8]）等。头痛疼痛强度增加与炎症（牛皮癣、过敏）、精神疾病（抑郁、焦虑）和睡眠状况（失眠）相关的合并症有关。增加 MHD 频率与几乎所有疾病的风险增加有关，在合并胃溃疡/胃肠道出血、糖尿病、焦虑、抑郁、失眠、哮喘和过敏/花粉症的患者中最为突出。结论 在控制社会人口学变量的回归模型中，偏头痛患者更常报告所研究的所有病症。无论是单独还是一起进入模型，头痛强度和 MHD 频率都与许多情况的风险增加有关。未来的工作需要理解关系的因果序列（直接因果关系、反向因果关系、