Determination of the frequency and type of headache in cases followed up with the diagnosis of overweight and obesity in the pediatric endocrinology clinic

Headache, being overweight, and obesity are common clinical manifestations in the pediatric population. The high incidence of headache is an important reason for referral to pediatric outpatient clinics and pediatric neurology outpatient clinics, as it affects the mental and physical conditions and school success of children. In this study, it was aimed to investigate the frequency and type of headache in children who were overweight or obese in childhood. In the study, between 15 December 2021 and 15 June 2022, in order to determine the frequency and type of headache in cases between the ages of 10-18, who were followed up in Aydın Adnan Menderes University Medical Faculty Hospital "Pediatric Endocrinology Polyclinic, with the diagnosis of overweight and obesity". It was planned to fill in a questionnaire form to evaluate the type and type. The files of the overweight and obese patients included in the study were scanned retrospectively, and demographic data, age at diagnosis, anthropometric measurements, body mass index, SDS score, arterial blood pressures, and follow-up times were obtained. In these cases, a questionnaire was applied to learn the presence, frequency and type of headache. By applying the same questionnaire to the healthy control group, it was planned to compare the data of overweight and obese children with those of normal weight children. In the study, the cases to be included in the study retrospectively were determined, and a prospective questionnaire study was performed on these cases. The study is a single-center, cross-sectional, clinical-based study. 394 cases were included in the study, 394 questionnaire data were obtained, and 390 questionnaires were evaluated. A total of 211 cases, including 66 overweight cases, 145 obese cases, and 60 morbidly obese cases, were included in the study group, and 179 cases were included in the control group. In our study, 80.3% of the overweight cases had headache complaints, of which 18.9% were diagnosed with migraine, 20.8% met the diagnostic criteria for GBA, and the remaining 60.4% were included in the unclassifiable headache group. Headache was present in 84.8% of the obese cases, 22% of them were diagnosed with migraine, 24.4% met the diagnostic criteria for GBA, and the remaining 53.7% were included in the unclassifiable headache group. 59 (98.3%) of 60 morbidly obese patients had headache complaints, 25.4% of them were included in migraine, 27.1% in TBA, 47.5% in unclassifiable headache group, and in the control group, which included normal weight patients, 179 patients. Of 132 cases (73.7%) with headache, 13.6% met the diagnostic criteria for migraine, 20.5% for TBA, and the remaining 65.9% were included in the unclassifiable headache group. Migraine rate in female gender was 30.0% in overweight, 25.0% in obese, 25.0% in morbidly obese, and 16.3% in normal weight patients, respectively. In females, the rate of GBA was 20.0% in overweight cases, 30.3% in obese cases, 32.5% in morbidly obese, and 23.8% in normal-weight cases. In our study, the frequency of headache was found to be significantly higher in overweight, obese and morbidly obese patients compared to normal weight patients (p<0.05), and the frequency of migraine in overweight and obese children was found to be numerically higher than in normal weight patients (p>0.05). Migraine frequency was found to be significantly higher in morbidly obese patients than in normal weight patients (p<0.05), and in overweight and obese patients compared to normal weight patients, in overweight, obese and morbidly obese patients, TTH was found to be numerically higher than in normal weight patients, but it was not statistically significant (p>0.05). As a result, in this study, headache frequency was found to be significantly higher in overweight, obese and morbidly obese patients compared to normal weight patients, but there was no significant difference in migraine frequency in overweight or obese patients compared to normal weight patients. However, according to the results of our study, since the frequency of headache and migraine was found to be significantly higher in morbidly obese patients than in normal weight patients, it was shown that the severity of obesity increased the frequency of headache and migraine. The high rates of unclassifiable headache in all groups suggest that the questionnaire questions could not be evaluated in terms of the subjects in the study and control groups. Key words: Pediatric patient, headache, migraine, tension-type headache, overweight, obesity