Association between the prognostic nutritional index and severe headache or migraine: a population-based study

Association between prognostic nutritional index and diabetic retinopathy among U.S. diabetic adults in NHANES

Diabetic retinopathy (DR) is characterized by progressive retinal vascular damage that ultimately causes vision loss. The prognostic nutritional index (PNI), which integrates albumin and lymphocytes, serves as an indicator of an individual's inflammatory response, nutritional condition, and immune system function. This research aimed to explore the possible association between PNI and DR. This was a cross-sectional study utilizing data from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2018. Weighted logistic regression analyses were employed to assess the relationship between PNI and DR prevalence. A total of 4791 adults aged 20 years and older were included in the analysis. Results indicated a statistically significant negative correlation between PNI and DR prevalence. In the fully adjusted model, a one-unit rise in PNI corresponded to a 7% reduction in the probability of DR prevalence. Quartile analysis consistently indicated that individuals in the highest PNI quartile had notably lower odds of DR prevalence compared to those in the lowest quartile. Additionally, smooth curve fitting suggested a nonlinear relationship between PNI and DR. Subgroup analysis reinforced the strength of the inverse association between PNI and DR (all p for interaction > 0.05). This nationally representative study demonstrated a significant inverse relationship between PNI levels and DR prevalence among diabetic adults in the United States. Our findings emphasize the potential role of maintaining optimal PNI values in preventing the development of DR.

Association Between Dietary Alcohol Intake and Migraine or Severe Headache Miscellaneous Pain: The NHANES 1999-2004

BACKGROUND

The relationship between alcohol consumption and migraine or severe headache remains controversial in the existing literature. Given that alcohol is a widely consumed beverage, clarifying the relationship between alcohol and migraine or severe headaches can help manage the patient's condition.

AIM

This study aimed to investigate the potential relationship between alcohol consumption and migraine or severe headache.

METHODS

Employing National Health and Nutrition Examination Survey (NHANES) database records spanning March 1999 to December 2004, our analysis encompassed threshold effects, smoothed curve fitting, and multivariate logistic regression to elucidate the relationship between alcohol consumption level and migraine or severe headaches. We utilized subgroup analyses and interaction tests to explore the stability of this relationship across different stratified populations.

RESULTS

A total of 13,083 subjects were enrolled. The odds of migraine or severe headache decreased with increasing dietary alcohol intake. This was more pronounced in the older and male subgroups.

CONCLUSIONS

There was a significant negative association between dietary alcohol intake and the odds of having migraine or severe headache.

Association of Admission Nutritional Status Evaluated by Prognostic Nutritional Index with One-Year Walking Independence after Primary Total Hip Arthroplasty for Osteonecrosis of the Femoral Head: A Retrospective Matched Cohort Study Based on 1,152 Patients

BACKGROUND

Malnutrition is significantly associated with unfavorable outcomes, but the relevant prognostic assessment is not emphasized in patients who have osteonecrosis of the femoral head (ONFH). This study aimed to assess the association between preoperative nutritional status evaluated by the prognostic nutritional index (PNI) and walking independence at one year postoperatively in patients who have ONFH undergoing primary total hip arthroplasty (THA).

METHODS

This was a retrospective analysis of prospectively collected data from patients admitted to a tertiary referral hospital who had ONFH and underwent primary unilateral THA from October 30, 2014 to April 26, 2019. The restricted cubic spline was used to assess the dose-effect relationship between PNI and recovery of walking independence. Propensity score matching was performed to balance potential preoperative confounders, and multivariable conditional logistic regression analysis was applied to assess the association between malnutrition and losing walking independence (LWI) with perioperative and follow-up factors for further adjustment. Inverse probability treatment weighting and sensitivity analyses were performed to test the robustness of the results. Subgroup analyses were used to determine potential population heterogeneity.

RESULTS

We found a negative relationship between admission PNI levels and recovery of walking independence at one year postoperatively, and that low PNI (< 42.2) was independently associated with a 2.35-fold (95% CI [confidence interval], 1.16 to 4.77; P = 0.018) increased risk of LWI. The results were overall robust. Significant heterogeneities were observed in the subgroups of age, labor intensity, American Society of Anesthesiologists class, Charlson's comorbidity index, and Association Research Circulation Osseous stage (P for interaction < 0.05).

CONCLUSIONS

Preoperative low-level PNI is a significant risk factor for LWI after THA in patients who have ONFH. This finding supports nutritional screening and interventions for surgeons in decision-making for elective surgery and postoperative rehabilitation management.

Association between prognostic nutritional index and stroke: A nationally representative cross-sectional study from NHANES

BACKGROUND

The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.

OBJECTIVE

The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.

METHODS

A cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.

RESULTS

The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02).

CONCLUSION

Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.

Association between dietary vitamin C intake and migraine in adults: A cross-sectional study of the National Health and Nutrition Examination Survey

BACKGROUND

Previous studies indicate that vitamin C may decrease the occurrence and intensity of migraines, but the evidence is restricted due to small sample sizes. This study aimed to determine the magnitude of the association between dietary vitamin C intake and migraine in the general population.

METHODS

This cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. Participants who had severe headaches or migraines in the past 3 months were classified as experiencing migraines. Dietary vitamin C intake was evaluated using the 24-h dietary recall system. Logistic regression models, restricted cubic spline (RCS) regression and stratified analyses were employed to assess the association between dietary vitamin C intake and migraine.

RESULTS

The study included 4101 participants, of whom 702 (17.12%) experienced migraine. The study revealed an inverse association between dietary vitamin C intake and migraine (odds ratio [OR] = 0.89, 95% confidence intervals [CI] = 0.83-0.96, p = 0.002) after adjusting for demographic covariates, lifestyle covariates, laboratory tests, physical examinations, physical activity, dietary covariates and comorbidities. When vitamin C intake was categorised, the adjusted OR (95% CI) for migraine in Q4 (highest vitamin C intake) was 0.64 (95% CI = 0.49-0.84, p = 0.001) compared to Q1 (lowest vitamin C intake). The RCS regression showed a linear inverse relationship between dietary vitamin C intake and migraine (pnon-linearity = 0.449). The findings remained consistent, and no significant interactions were found among different groups.

CONCLUSIONS

Dietary vitamin C intake was inversely associated with migraine, and a linear negative relationship was found between vitamin C intake and migraine.

Prognostic nutritional index and albuminuria in adults aged 20 years and above: a cross-sectional analysis in the United States

Background and objective

Albuminuria is an important early marker of kidney damage and progression of chronic kidney disease and is also linked to several chronic systemic diseases. The Prognostic Nutritional Index (PNI) is widely used in the assessment of multiple diseases. However, research dealing with the relationship between PNI and albuminuria remains scarce. This research project aims to examine this association.

Methods and materials

The present study employed data from the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2020, including 7,737 adult participants who met the study criteria. PNI was analyzed as a quartile-categorized variable. Multivariable regression models and smoothing curve fitting were adopted to examine the relationship between PNI and albuminuria. In order to ascertain the stability of the association across different populations, subgroup analyses were performed.

Results

The study found a statistically significant inverse relationship between higher PNI levels and the prevalence of albuminuria. The fully adjusted model indicates that a one-unit increase in PNI is associated with a 4% reduced odds of albuminuria prevalence [0.96 (0.93, 0.98)]. Quartile analysis showed a stable inverse relationship, with the highest PNI quartile having the significantly lower odds of albuminuria prevalence [0.76 (0.62, 0.94), p for trend = 0.0004]. Smooth curve fitting and two-piecewise linear regression models indicated a nonlinear relationship between PNI and albuminuria, with a turning point at 42. Subgroup analysis confirmed the reliability of the inverse relationship between PNI and albuminuria across all groups.

Conclusion

The findings of this study indicated that higher PNI levels are significantly inversely related to the odds prevalence of albuminuria. PNI could serve as an important predictor for the occurrence of albuminuria. Further prospective studies are needed to validate this association.

Practical supplements for prevention and management of migraine attacks: a narrative review

Background

Migraine is one of the most debilitating neurological disorders that causes frequent attacks of headaches and affects approximately 11% of the global population. Deficient or even insufficient levels of vital nutrients would increase the severity and frequency of migraine attacks. Therefore, we aimed to examine the practical supplements for the prevention and management of migraine attacks.

Method

This narrative review study was conducted by searching PubMed, ISI web of science, EMBASE, Google Scholar, and Scopus using the keywords of "dietary supplement" and "migraine" plus their MeSH terms. Original articles published in English language from their inception to July 27th, 2024, studies that investigated adult population (aged >18 years), and those assessing the impact of intended nutrient supplementation on clinical symptoms of migraine were included in the study.

Result

Oxidative stress and low intake of antioxidants would be risk factors for migraine attacks by inducing inflammation. The secretion of inflammatory cytokines, such as tumor necrosis factor (TNF)-a, would lead to neuroinflammation and migraine episodes by increasing the cellular permeability and interactions. Evidence also indicated a direct association between phases of migraine attacks and calcitonin gene-related peptide (CGRP), mitochondrial disorders, monoaminergic pathway, disruption in brain energy metabolism, and higher serum levels of glutamate and homocysteine. Therefore, supplementation with nutrients involved in mitochondrial function, brain energy metabolism, and even methyl donors would relieve migraine attacks.

Conclusion

Evidence indicated that supplementation with riboflavin, omega-3 fatty acids, alpha lipoic acid, magnesium, probiotics, coenzyme Q10, ginger, and caffeine would have favorable effects on migraine patients. However, more prospective studies are required to evaluate the effect of other nutrients on migraine patients.

Association Between Copper Intake and Migraine: a National Cross-sectional Study

Migraine is a common clinical neurological disorder that adversely affects humans and society. The relationship between copper intake and migraine has been less studied and controversial. The purpose of this study was to determine the relationship between copper intake and migraine and to guide dietary interventions. The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2004, involving a total of 12,724 participants. The relationship between copper intake and migraine was examined using weighted multivariate logistic regression models, and smooth-fit curves were plotted to explore the relationship. After non-linear relationships were found, recursive algorithms and two-stage linear regression models were used to calculate inflection points. Stratified analyses were also performed to explore population differences. In the model corrected for all covariates, the OR (95% CI) of copper intake with migraine was 1.19 (0.97, 1.46), which was not statistically significant. However, the results of the linear trend test suggested that their relationship might be non-linear. Smooth-fit curves confirmed the non-linear relationship between copper intake and migraine, and an inflection point (0.98 mg/day) was identified. There was no statistical significance before the inflection point, but after the inflection point, copper intake was positively associated with migraine attacks. Stratified analyses showed that this non-linear relationship persisted in females, people under 45 years old, and people with BMI less than 30. In this large cross-sectional study, we found a non-linear correlation between copper intake and migraine.

Association between severe headache or migraine and lipid accumulation product and visceral adiposity index in adults: a cross-sectional study from NHANES

BACKGROUND

Existing literature on the impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on severe headache or migraine is limited. This study aims to elucidate the association between LAP and VAI and the prevalence of migraine.

METHODS

Data for this study were sourced from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). A database-self-administered questionnaire was used to assess severe headache or migraine. A weighted logistic regression model was employed to assess the relationship between LAP and VAI with migraine prevalence. Complementary analytical approaches included subgroup analysis, restricted cubic spline (RCS), and threshold effect analysis to validate the findings.

RESULTS

In the end, 4572 people were recruited for the research, including 880 with migraine and 3692 without migraine. Following adjustment for the relevant covariables, weighted logistic regression analysis (OR = 1.409, 95% CI: 1.054, 1.883, P = 0.022; OR = 1.288, 95% CI: 1.010, 1.642, P = 0.042) revealed significantly elevated odds of migraine prevalence in participants within the highest tertile (T3) of LAP and VAI than those in the lowest tertile (T1). The nonlinear association between migraine prevalence and both VAI and LAP was further elucidated through a restricted cubic spline. The threshold analysis pinpointed 2.142 (log-likelihood ratio = 0.016) as the critical inflection point for VAI. Subgroup analysis and interaction testing revealed the significant association was independent in different subgroup factors.

CONCLUSIONS

The data indicate a robust association between higher levels of LAP and VAI and an increased prevalence of migraine.

Association of dietary vitamin C consumption with severe headache or migraine among adults: a cross-sectional study of NHANES 1999-2004

Background

An antioxidant-rich diet has been shown to protect against migraines in previous research. However, little has been discovered regarding the association between migraines and vitamin C (an essential dietary antioxidant). This study assessed the dietary vitamin C intake among adult migraineurs in the United States to determine if there is a correlation between migraine incidence and vitamin C consumption in adults.

Methods

This cross-sectional research encompassed adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004, providing detailed information on their dietary vitamin C intake as well as their history of severe headaches or migraines. The study used weighted multivariable and logistic regression analyses to find an independent connection between vitamin C consumption and severe headache or migraine. Tests of interactions and subgroup analysis were conducted.

Results

Among the 13,445 individuals in the sample, 20.42% had a severe headache or migraine. In fully adjusted models, dietary vitamin C consumption was substantially linked negatively with severe headache or migraine (odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.91-0.98, p = 0.0007). Compared to quartile 1, quartile 4 had 22% fewer odds of having a severe headache or migraine (OR = 0.78, 95% CI = 0.69-0.89, p = 0.0002). Subgroup analyses showed a significant difference between vitamin C intake and severe headaches or migraines by gender (p for interaction < 0.01).

Conclusion

Reduced risk of severe headaches or migraines may be associated with increased consumption of vitamin C.

Age and sex differences in the association between Dietary Inflammatory Index and severe headache or migraine: a nationwide cross-sectional study

BACKGROUND

Migraine and severe headaches are extremely prevalent neurological disorders that plague humans and society. Prior research has revealed that DII may affect the occurrence of migraines, but there are too few relevant studies and more are required. This study aimed to determine the association between severe headache or migraine and the Dietary Inflammatory Index (DII), with particular attention to age and gender differences.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES), we performed a cross-sectional study. In addition, we investigated the association between DII and severe headache or migraine using weighted multivariate logistic regression models, and restricted cubic splines models were plotted to explore their linear correlation.

RESULTS

There were a total of 13,439 people participating in the study, and of those, 2745 experienced a severe headache or migraine within the previous three months. The DII was linearly and positively correlated with severe headache or migraine (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 1.01-1.08, p = 0.0051). Stratified analysis showed that this relationship persisted among women and those aged < 60 years, with ORs of 1.08 (95% CI = 1.04-1.13, p = 0.0004) and 1.05 (95% CI = 1.01-1.09, p = 0.0071), respectively.

CONCLUSIONS

We found that greater levels of DII were significantly related to an increased likelihood of migraine onset, especially among women and young and middle-aged populations. Further research is required to validate and expand upon our results.

Association between oxidative balance score and self-reported severe headache or migraine based on NHANES 1999 to 2004 data: A cross-sectional study

Purpose

The pathophysiological mechanisms underlying migraine remain elusive, with oxidative stress hypothesized as a potential etiological factor. The Oxidative Balance Score (OBS) is a comprehensive tool for assessing the impact of diet and lifestyle on oxidative stress, thereby gauging an individual's overall antioxidant capacity. In this cross-sectional study, we explored the correlation between OBS and migraine prevalence among a cohort of US adults.

Methods

We analyzed data from 6195 participants aged 20 years and above, drawn from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. We employed multiple logistic regression, coupled with sensitivity analyses, to investigate the relationship between OBS and migraine. Subsequent subgroup analyses and interaction tests were performed to assess the consistency of this association across the population.

Results

Multiple logistic regression revealed an inverse relationship between OBS and the likelihood of experiencing migraines. Specifically, individuals in the highest OBS quartile exhibited a significantly reduced migraine risk compared to those in the lowest quartile (OR = 0.98, 95% Confidence Interval (CI): 0.97-0.99, P = 0.0001). Furthermore, restricted cubic spline curves indicated a non-linear association between dietary OBS and migraine incidence (non-linear P = 0.0258).

Discussion

Our findings suggest that adherence to an antioxidant-rich diet may be an effective strategy for mitigating migraine, potentially by influencing oxidative balance.

Association between Oxidative Balance Score and Severe Headache or Migraine among American Adults A Cross-Section Study

BACKGROUND

Migraine is implicated in oxidative stress. The oxidative balance score (OBS) assesses the combined impact of diet and lifestyle on oxidative and antioxidant balance in diseases. However, the association between OBS and migraine remains underexplored.

OBJECTIVE

We aimed to examine the relationship between OBS and severe headaches or migraines among American adults.

METHODS

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, defining severe headaches or migraine via self-reports and calculating OBS from 16 diaries and 4 lifestyle factors. Multivariable weighted logistic regression models were used to explore the OBS-migraine relationship, with stratified analysis for result validation.

RESULTS

The study included 6,653 participants (average age 45.6, 52.1% male), and 19.1% reported severe headaches or migraines. There was a significant inverse association between OBS and severe headache or migraine, with an adjusted odds ratio (OR) of 0.97 (95% [confidence interval] CI: 0.96, 0.98, p < 0.001). The highest OBS tertile had an adjusted OR of 0.58 (95% CI: 0.47, 0.73) compared to the lowest. This pattern was consistent across sexes, with an adjusted OR of 0.98 (0.95, 1.00) in males and 0.97 (0.95, 1.00) in females. The adjusted OR for migraine was 0.61 (0.44, 0.87) and 0.54 (0.37, 0.79) in the highest tertile for males and females, respectively.

CONCLUSION

The study highlights a significant association between OBS and severe headaches or migraines, suggesting the potential role of oxidative stress in these conditions. The findings emphasize the importance of a balanced, antioxidant-rich diet and lifestyle in managing severe headaches or migraine.

Association of prognostic nutritional index with the risk of all-cause mortality and cardiovascular mortality in patients with type 2 diabetes: NHANES 1999-2018

INTRODUCTION

There is little bulk clinical evidence on nutritional status and mortality in patients with diabetes. The purpose of this study was to examine the relationship between prognostic nutritional index (PNI) and all-cause mortality and cardiovascular mortality in adults with diabetes.

RESEARCH DESIGN AND METHODS

This study included 5916 adult patients with diabetes from the National Health and Nutrition Examination Survey 1999-2018. Cox proportional risk models were used to estimate risk ratios (HRs) and 95% CIs for all-cause mortality, cardiovascular disease (CVD) mortality.

RESULTS

During a mean follow-up of 8.17 years, there were 1248 deaths from all causes and 370 deaths from CVD. After multivariate adjustment, the risk of all-cause mortality was reduced by 24%, 38%, and 28% in Q2 (49.0-52.99), Q3 (53.0-57.99), and Q4 (≥58.0), respectively, compared with Q1 (PNI<49.0). The risk of cardiovascular mortality was reduced by 30%, 27%, and 26%, respectively. Consistent results were observed in the subgroup analysis.

CONCLUSIONS

Lower serum PNI levels were significantly associated with higher all-cause and CVD mortality. These findings suggest that maintaining an appropriate range of serum PNI status may reduce the risk of death in patients with diabetes.

Association between Malnutrition and Migraine Risk Assessed Using Objective Nutritional Indices

Dietary triggers are frequently linked to migraines. Although some evidence suggests that dietary interventions might offer a new avenue for migraine treatment, the connection between migraine and nutrition remains unclear. In this study, we explored the association between nutritional status and migraines. Clinical data spanning 11 years were sourced from the Smart Clinical Data Warehouse. The nutritional statuses of 6603 migraine patients and 90,509 controls were evaluated using the Controlling Nutrition Status (CONUT) score and the Prognostic Nutrition Index (PNI). The results showed that individuals with mild, moderate, and severe malnutrition were at a substantially higher risk of migraines than those with optimal nutrition, as determined by the CONUT score (adjusted odds ratio [aOR]: 1.72, 95% confidence interval [CI]: 1.63-1.82; aOR: 5.09, 95% CI: 4.44-5.84; aOR: 3.24, 95% CI: 2.29-4.59, p < 0.001). Similarly, moderate (PNI: 35-38) and severe (PNI < 35) malnutrition were associated with heightened migraine prevalence (aOR: 4.80, 95% CI: 3.85-5.99; aOR: 3.92, 95% CI: 3.14-4.89, p < 0.001) compared to those with a healthy nutritional status. These findings indicate that both the CONUT and PNI may be used as predictors of migraine risk and underscore the potential of nutrition-oriented approaches in migraine treatment.

Association between urinary caffeine and caffeine metabolites and stroke in American adults: a cross-sectional study from the NHANES, 2009-2014

This study investigates the potential correlation between urinary caffeine levels and the occurrence of stroke, a serious cerebrovascular disease that can lead to disability or death. The data used in this study was obtained from the National Health and Nutrition Examination Survey conducted between 2009 and 2014. The study analyzed a total of 5,339 individuals, divided into a control group (n = 5,135) and a stroke group (n = 162). The researchers utilized multiple logistic regression and smoothed curve fitting to examine the relationship between urinary caffeine and caffeine metabolites and the incidence of stroke. The study found that higher urinary caffeine levels were associated with a lower risk of stroke in Mexican American participants (odds ratio [OR] = 0.886, 95% confidence interval [CI]: (0.791, 0.993), P = 0.037). After adjusting for certain participant characteristics, it was also found that higher urinary paraxanthine levels were associated with a lower risk of stroke incidence (OR = 0.991, 95% CI (0.984, 0.999), P = 0.027). Meanwhile, the highest urinary paraxanthine levels group had 43.7% fewer strokes than the lowest level group (OR = 0.563, 95% CI (0.341, 0.929), P = 0.025). In this study, we showed a negative link between urine paraxanthine levels and the risk of stroke. Meanwhile, urinary caffeine levels were negatively associated with the incidence of stroke in Mexican Americans, but no correlation in other populations. Our findings may have predictive and diagnostic implications in clinical practice. Further extensive prospective investigations are still needed to validate our conclusions.

Association between selenium intake and migraine: a nationwide cross-sectional study

Background

Dietary interventions for migraine are receiving increasing attention. However, it remains unclear whether there is any relationship between migraine and selenium intake. The aim of this study was to investigate the association between selenium intake and migraine.

Methods

We used multivariate logistic regression equations to explore the association between selenium intake and migraine. Restricted cubic splines were used to examine the presence of non-linear relationships. Upon finding a non-linear relationship, a recursive algorithm was used to calculate the inflection point. Population differences were also explored through stratified analysis.

Results

In the model adjusted for all covariates, the ORs (95% CI) for the association between selenium intake and migraine were 0.96 (0.88, 1.04), which was no statistical significance. However, the result of the linear trend test with quadrilles of selenium intake indicated the association between selenium intake and migraine may be non-linear. The restricted cubic splines confirmed this non-linear relationship, finding an inflection point (93.1 mcg/day), where the odds of migraine decreased with increasing selenium intake before the inflection point, and no statistically significant relationship was found after the inflection point. The association between selenium intake and migraine was non-linear in all strata except the obese.

Conclusion

We found a non-linear association between selenium intake and migraine in the general American population.