Effect of sucrose consumption on serum insulin, serum cortisol and insulin sensitivity in migraine: Evidence of sex differences

- Level of insulin after eating sugar is not the same in male and female migraineurs.
- Level of insulin after eating sugar is higher in female migraineurs.
- Effect of sugar on insulin sensitivity in male and female migraineurs is different.
- Sugar-induced insulin resistance develops after 120 min in female migraineurs.

The aim of this study was to compare the effect of sucrose on biomarkers of energy metabolism and utilization in migrainous men and women. A total of 20 participants (7 = Migraine (female), 5 = Migraine (male), 8 = Non-migraine control) submitted to an oral sucrose tolerance test (OSTT), which required them to fast for 15 h overnight and then ingest 75 g sucrose dissolved in 175 g water at 9 AM the next morning. Blood sampling for the assessment of serum insulin, serum cortisol and plasma glucose was conducted upon arrival at 0900 h and then at regular 15-min intervals across a 150-min period. Comparison of insulin sensitivity indexes that rely on fasting glucose and insulin data failed to find evidence of insulin resistance in migraineurs or controls. Prior to sucrose consumption the level of fasting serum cortisol at 0-min on average was significantly higher in migraineurs. However, no significant group differences in the level of fasting serum insulin and plasma glucose at 0-min were noted. Following sucrose consumption: the level of serum insulin was significantly higher in female migraineurs; the level of serum cortisol was significantly higher in male migraineurs; glucose/insulin (G/I) ratio was significantly higher in male migraineurs at 135-min and 150-min; insulin/cortisol (I/C) ratio was significantly different with the I/C ratio lower in male migraineurs and higher in female migraineurs; area under the curve (AUC) insulin was significantly different across groups with AUC insulin lower in male migraineurs and higher in female migraineurs; and AUC cortisol was significantly higher in male migraineurs. It was concluded that the effect of sucrose on biomarkers of energy metabolism and utilization in male and female migraineurs is not the same. Therefore, the factors underlying migraine pathogenesis in men and women may also be different.