Telomere Length Exhibits Inverse Association with Migraine Among Americans Aged 20-50 Years, without Implications Beyond Age 50: A Cross- Sectional Study

Abstract

Abstract Migraine, highly prevalent among individuals under 50 years, is associated with oxidative stress. Telomere length shortening, closely linked to oxidative stress and aging, has not been comprehensively studied in its association with migraine and potential age-related influence. This cross-sectional study included data from 6,169 participants in the National Health and Nutrition Survey (NHANES) from 1999 to 2002. This encompassed information on peripheral blood leukocyte telomere length, severe headache or migraine, and potential confounders. Stratifying by age (20–50 years, > 50 years), we employed multivariable logistic regression and restricted cubic splines to investigate the relationship between telomere length and migraine. Further interaction test revealed age-influenced telomere length in relation to migraine. In participants aged 20–50 years, the odds ratio (OR) for migraine in the shortest telomere length group T1 (0.39–0.89) was 1.35 (95% confidence interval [95% CI]: 1.01, 1.79) compared to the longest group T3 (1.10–9.42), whereas in those aged > 50 years, the OR for the T1 group was 0.93 (95% CI: 0.60, 1.43). Additionally, telomere length and age interacted in the development of migraine (p for interaction: 0.010). Further analysis showed an L-shaped relationship between telomere length and migraine incidence in people aged 20–50 years, with an OR of 9.34 (95% CI: 1.56, 55.99) for migraine at telomere length < 1.02 T/S ratio. These findings revealed that age may influence the association between telomere length and migraine in U.S. adults. For Americans aged 20–50, telomere length demonstrated an L-shaped association with migraine, with an approximate inflection point at 1.02 T/S ratio.