Atherogenic index of plasma and severe headaches or migraines risk in US adults: a population-based cross-sectional analysis from NHANES 1999-2004.

Background: Despite the established link between the atherogenic index of plasma (AIP) and cardiometabolic diseases, its association with severe headaches or migraines remains poorly characterized. This study aimed to explore the association between AIP and severe headaches or migraines using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Data were drawn from the NHANES 1999-2004, comprising 6,017 adults. AIP was calculated as log10 [triglycerides/high-density lipoprotein cholesterol (HDL-C)] and stratified into quartiles. Severe headaches or migraines status was identified through self-reported responses. Survey-weighted multivariable logistic regression was used to evaluate the association between AIP and the risk of severe headaches or migraines, with restricted cubic spline (RCS) models employed to characterize the dose-response relationship. Subgroup and sensitivity analyses were performed to assess consistency and robustness. Results: Among 1,218 severe headache or migraine patients, baseline characteristics revealed that severe headache or migraine patients were predominantly younger (<45 years: 57.6%), female (57.6%), and had higher smoking rates (56.6%). Higher risk of severe headaches or migraines was observed in the second (Q2: 26.5%) and fourth quartiles (Q4: 27.2%) of AIP. After full adjustment, Q2 ( Conclusion: Elevated AIP was associated with self-reported severe headaches or migraines in this cross-sectional analysis, though a consistent dose-response relationship was not established. These findings suggest a potential link with lipid metabolism, but causality cannot be inferred. Prospective studies are required to further evaluate this association.