Abstract：
OBJECTIVE: To assess the association between hypermobility spectrum disorders/hypermobile type Ehlers Danlos Syndrome (HSD/hEDS) and migraine in a national sample of adolescents in Israel.
BACKGROUND: The association between HSD/hEDS and migraine is unclear, even more so in pediatric populations.
METHODS: This population-based, cross-sectional study included 1,627,345 Israeli adolescents (945,519/1,626,407 [58%] males; mean age 17 ± 0.5 years) who were medically assessed before mandatory military service during 1998-2020. Diagnoses of migraine with at least one attack per month (active migraine) and HSD/hEDS were confirmed by certified specialists. The prevalences of active migraine in adolescents with and without HSD/hEDS were computed and the association between HSD/hEDS and active migraine was examined.
RESULTS: Active migraine was significantly more prevalent in adolescents with HSD/hEDS (307/4686 [6.5%]) compared to those without HSD/hEDS (51,931/1,621,721 [3.2%]) (OR = 2.16, 95% CI 1.90-2.45). The association between HSD/hEDS and active migraine persisted in a multivariable analysis (OR = 2.08, 95% CI 1.85-2.34) and in several sensitivity analyses.
CONCLUSIONS: We found a significant association between HSD/hEDS and active migraine in both male and female adolescents. Clinical awareness of the association can promote early diagnosis and treatment of migraine. Further research is required to identify appropriate pharmacologic and nonpharmacologic migraine treatment strategies for individuals with HSD/hEDS.
BACKGROUND: The association between HSD/hEDS and migraine is unclear, even more so in pediatric populations.
METHODS: This population-based, cross-sectional study included 1,627,345 Israeli adolescents (945,519/1,626,407 [58%] males; mean age 17 ± 0.5 years) who were medically assessed before mandatory military service during 1998-2020. Diagnoses of migraine with at least one attack per month (active migraine) and HSD/hEDS were confirmed by certified specialists. The prevalences of active migraine in adolescents with and without HSD/hEDS were computed and the association between HSD/hEDS and active migraine was examined.
RESULTS: Active migraine was significantly more prevalent in adolescents with HSD/hEDS (307/4686 [6.5%]) compared to those without HSD/hEDS (51,931/1,621,721 [3.2%]) (OR = 2.16, 95% CI 1.90-2.45). The association between HSD/hEDS and active migraine persisted in a multivariable analysis (OR = 2.08, 95% CI 1.85-2.34) and in several sensitivity analyses.
CONCLUSIONS: We found a significant association between HSD/hEDS and active migraine in both male and female adolescents. Clinical awareness of the association can promote early diagnosis and treatment of migraine. Further research is required to identify appropriate pharmacologic and nonpharmacologic migraine treatment strategies for individuals with HSD/hEDS.
摘要：
目的：在以色列全国青少年样本中评估高移动频谱障碍/高移动型EhlersDanlos综合征（HSD/hEDS）与偏头痛之间的关联。
背景：HSD/hEDS与偏头痛之间的关联尚不清楚，在儿科人群中更是如此。
方法：这种以人口为基础的，横断面研究包括1,627,345名以色列青少年（945,519/1,626,407[58％]男性；平均年龄17±0.5岁），他们在1998-2020年期间服兵役前接受了医学评估。经认证的专家确认了每月至少一次发作的偏头痛（活动性偏头痛）和HSD/hEDS的诊断。计算了有和没有HSD/hEDS的青少年中活动性偏头痛的患病率，并检查了HSD/hEDS与活动性偏头痛之间的关系。
结果：与没有HSD/hEDS的青少年相比，患有HSD/hEDS的青少年活动性偏头痛（307/4686[6.5%]）明显更普遍（51,931/1,621,721[3.2%]）（OR=2.16,95%CI1.90-2.45）。在多变量分析（OR=2.08，95％CI1.85-2.34）和一些敏感性分析中，HSD/hEDS与活动性偏头痛之间的关联仍然存在。
结论：我们发现在男性和女性青少年中，HSD/hEDS与活动性偏头痛之间存在显著关联。临床对这种关联的认识可以促进偏头痛的早期诊断和治疗。需要进一步的研究来确定HSD/hEDS患者的药物和非药物偏头痛治疗策略。
背景：HSD/hEDS与偏头痛之间的关联尚不清楚，在儿科人群中更是如此。
方法：这种以人口为基础的，横断面研究包括1,627,345名以色列青少年（945,519/1,626,407[58％]男性；平均年龄17±0.5岁），他们在1998-2020年期间服兵役前接受了医学评估。经认证的专家确认了每月至少一次发作的偏头痛（活动性偏头痛）和HSD/hEDS的诊断。计算了有和没有HSD/hEDS的青少年中活动性偏头痛的患病率，并检查了HSD/hEDS与活动性偏头痛之间的关系。
结果：与没有HSD/hEDS的青少年相比，患有HSD/hEDS的青少年活动性偏头痛（307/4686[6.5%]）明显更普遍（51,931/1,621,721[3.2%]）（OR=2.16,95%CI1.90-2.45）。在多变量分析（OR=2.08，95％CI1.85-2.34）和一些敏感性分析中，HSD/hEDS与活动性偏头痛之间的关联仍然存在。
结论：我们发现在男性和女性青少年中，HSD/hEDS与活动性偏头痛之间存在显著关联。临床对这种关联的认识可以促进偏头痛的早期诊断和治疗。需要进一步的研究来确定HSD/hEDS患者的药物和非药物偏头痛治疗策略。
