Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischaemic stroke

Tu, Wen‐Jun; Zhao, Shengjie; Xu, Dong-Jiang; Chen, Hui

doi:10.1042/cs20130284

Cited by 105 publications

(82 citation statements)

References 43 publications

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“…These findings were consistent with those of previous studies, which showed 68-78% prevalence of vitamin D deficiency in the Chinese acute ischemic stroke population [14,15] . Our findings have confirmed the results of the previous studies, which suggested that 25(OH) D is a prognostic marker of functional outcome and death in patients with acute ischemic stroke and hemorrhagic stroke [13,14] .…”

Section: Discussionsupporting

confidence: 83%

“…The MESA study demonstrated that vitamin D deficiency is associated with incident coronary heart disease in white or Chinese but not in black or Hispanic participants [12] . Recently, a few studies have suggested the association between vitamin D status and functional outcome of acute stroke [13][14][15] . However, it remains to be determined whether a low vitamin D level is associated with stroke outcome.…”

Section: Introductionmentioning

confidence: 99%

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Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke

et al. 2015

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Background: Low 25-hydroxyvitamin D (25(OH)D) concentrations have been shown to predict risk of cardiovascular disease and all-cause mortality. Although the prevalence of 25(OH)D deficiency is high in patients with acute stroke, the prognostic value of 25(OH)D in stroke has not been clearly established. The purpose of this study was to determine whether the baseline serum 25(OH)D level was associated with the functional outcome in patients with acute ischemic stroke. Methods: From June 2011 to January 2014, consecutive patients with acute ischemic stroke within 7 days of symptom onset were enrolled in this study from a prospectively maintained stroke registry. Serum 25(OH)D level was measured at admission. Clinical and laboratory data including stroke severity using the National Institute of Health Stroke Scale (NIHSS) score were collected during admission, and the functional outcome at 3 months was assessed by modified Rankin scale (mRS). The association between the baseline 25(OH)D level and a good functional outcome (mRS 0-2) at 3 months was analyzed by multiple logistic regression models. Results: A total of 818 patients were enrolled in this study. Mean age was 66.2 (±12.9) years, and 40.5% were female. The mean 25(OH)D level was 47.2 ± 31.7 nmol/l, and the majority of patients met vitamin D deficient status (<50 nmol/l; 68.8%), while an optimal vitamin D level (≥75 nmol/l) was present in only 13.6% of the patients, and 436 (53.3%) patients showed good functional outcome at 3 months. Serum 25(OH)D levels in patients with good outcomes were significantly higher than those with poor outcome (50.2 ± 32.7 vs. 43.9 ± 30.0 nmol/l, p = 0.007). The 3-month functional outcome was significantly associated with month-specific 25(OH)D quartiles in multivariable logistic regression analysis. After adjustment for age and sex, the highest 25(OH)D quartile group had higher tendency for good functional outcome at 3 months (odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.13-2.51). After fully adjusting for other potential confounders, such as stroke severity and vascular risk factors, the association was further strengthened with an OR (95% CI) of 1.90 (1.14-3.16). Other factors associated with good functional outcome in multivariable analysis were younger age, lower initial NIHSS score and absence of diabetes. Conclusions: This study suggests that serum 25(OH)D level is an independent predictor of functional outcome in patients with acute ischemic stroke. Further studies are required to determine whether vitamin D supplementation could improve functional outcome in patients with ischemic stroke.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke

et al. 2015

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“…Vitamin D deficiency and insufficiency (77.5%) was very common in our patients. Median baseline 25(OH)D levels 14.03ng/ml in our patients were similar compared with other studies 15.2ng/ml 14 and 14.1 ng/ml 15 . Pathophysiological mechanisms remain speculative, but several possible biological mechanisms might explain the association of low 25(OH)D with poor outcome 16 .…”

Section: Discussionsupporting

confidence: 73%

“…In our study, we found that circulating serum 25(OH)D levels were deficient and insufficient in 77.5 % of patients with acute stroke. Another study in Chinese patients also found that vitamin D deficiency (78.6 %) was very common 15 . Tu et al also suggested that 25(OH)D was an independent predictor of major disability and death within 90 days after onset of ischemic stroke with ORs (95% CIs) of 0.79 (0.73-0.85) and 0.70 (0.50-0.98) respectively 16 .…”

Section: Resultsmentioning

confidence: 98%

Low Serum Vitamin D is Independently Associated with Acute Ischemic Stroke

et al. 2018

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“…A further study in China not only showed that patients with acute ischaemic stroke had significantly lower vitamin D levels compared to controls, but also that vitamin D levels were a prognostic marker of short-term functional outcome and death in stroke patients (Tu et al, 2014).…”

Section: Strokementioning

confidence: 99%

The role of adult vitamin D deficiency in cognition and brain function in mice

Groves¹

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Vitamin D deficiency is prevalent throughout the world. Even in a temperate climate such as Australia, one-third of the adult population has insufficient levels of serum vitamin D (25-hydroxyvitamin D levels <50 nmol/L). Epidemiological studies have shown significant associations between vitamin D deficiency and an increased risk of various neuropsychiatric and neurodegenerative disorders, such as schizophrenia, depression, Alzheimer's disease and cognitive impairment. However, studies based on observational epidemiology cannot address questions of causality; they cannot determine if vitamin D deficiency is a causal factor leading to the adverse health outcome. The use of animal experiments can examine the biological plausibility of the relationship between vitamin D deficiency and adverse brain outcomes.Vitamin D is a neurosteroid that has a wide range of functions within the brain including calcium maintenance, regulation of neurotrophic factors, neurogenesis, and neuroprotection. Using a model of adult vitamin D (AVD) deficiency in BALB/c mice, we have previously shown alterations in a range of behaviours and an imbalance between excitatory and inhibitory neurotransmission, which may be relevant to a range of neuropsychiatric disorders. Therefore, we have provided experimental evidence demonstrating that vitamin D deficiency in adulthood impacts on a range of brain functions, and is therefore a biologically plausible risk factor for the development of neuropsychiatric disorders. However, there is currently insufficient evidence to account for the mechanism(s) by which this occurs.There were four main aims of the thesis; to determine whether AVD deficiency impacts on (1) cognition, (2) adult hippocampal neurogenesis, and (3) glutamate and GABA signaling in BALB/c mice; and to determine if AVD deficiency would (4) exacerbate the effects of a secondary exposure, in this case social stress, in BALB/c mice and in the more resilient C57BL/6J mice.To address these aims I assessed attentional processing in BALB/c mice using the 5 choice serial reaction time task and found sex-dependent impairments in AVD-deficient male mice only.Structural and diffusion tensor imaging was assessed using MRI in male mice, however we found no significant alterations in gross brain structure or connectivity within the brain in the group exposed to AVD deficiency. I used immunohistological techniques to assess two measures of hippocampal neurogenesis, cell proliferation and survival of newborn neurons, and found that hippocampal neurogenesis was not affected by AVD deficiency at baseline or following wheel running stimulated neurogenesis.iii Despite no cellular level change in neurogenesis, the analysis of the proteomics of the hippocampus, although preliminary, provided clues that AVD deficiency may have an effect on synapse formation and plasticity, and dendritic arborisation and that these changes may be responsible for impaired learning and memory. The proteomics also provided convergent evidence of an effect on glutamate and...

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Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischaemic stroke

Cited by 105 publications

References 43 publications

Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke

Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke

Low Serum Vitamin D is Independently Associated with Acute Ischemic Stroke

The role of adult vitamin D deficiency in cognition and brain function in mice

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