Status of Vitamin D and its Association with Stroke Risk Factors in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital

Thapa, Lekhjung; Shrestha, Ashis; Pradhan, Manohar; Bhandari, TR; Shrestha, Shakti; Rs, Poudel; Poudel, Rajesh

doi:10.31729/jnma.2719

Cited by 10 publications

(13 citation statements)

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“…As a neurosteroid, vitamin D plays a vital role in preventing vascular injury through the mechanism of inhibiting the renin-angiotensin-aldosterone system and atherogenesis [7], lowering blood pressure, reduction in endothelial dysfunction [13], and neuroprotective actions in stroke [14]. Accumulating data have supported the hypothesis lower 25(OH)D level was associated with ischemic stroke, higher mortality and poor outcome [15][16][17][18][19][20][21][22][23][24][25][26], and a higher vitamin D was linked to a decreased risk of cerebrovascular disease [27]. These findings were also substantiated by the evidence of meta-analysis [28].…”

Section: Discussionmentioning

confidence: 99%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

BMC Neurol

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Background The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China. Methods We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12–20 ng/ml) and sufficiency (> 20 ng/ml). Results Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls ( P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level ( P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD ( OR 0.772, 95% CI 0.691–0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006–15.683) and 1.077 (95% CI : 0.338–3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398–39.540) and 1.108 (95% CI 0.232–5.280), respectively ( P interaction = 0.001). Conclusion We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

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Section: Discussionmentioning

confidence: 99%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

BMC Neurol

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Section: Discussionmentioning

confidence: 99%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

Preprint

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Background: The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such association between 25(OH) D and SVD in China. Methods: We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25(OH) D: vitamin D deficiency (<12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (>20 ng/ml). Results: Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6±13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P=0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P<0.05). Logistic regression analysis revealed the level of 25(OH)D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P=0.001). Compared with the sufficient 25(OH)D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (Pinteraction=0.001). Conclusion: We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

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“…The severity of the stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS) [12]. Stroke severity was categorized as mild (NIHSS score < 8), moderate (NIHSS score [8][9][10][11][12][13][14], and severe stroke (NIHSS score ≥ 15) [13]. Short-term functional outcome was measured using modified Rankin Scale (mRS) after 3-months.…”

Section: Stroke Severity and Outcome Assessmentmentioning

confidence: 99%

“…Moreover, deficiency of vitamin D influences vascular remodeling through modulation of smooth muscle cell proliferation, inflammation, and thrombosis. These vascular changes can eventually cause stroke [10].…”

Section: Introductionmentioning

confidence: 99%

Serum vitamin D levels in acute stroke patients

Selim

Fahmi

Ali

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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Background: Vitamin D deficiency has been proposed as a risk factors of cerebrovascular stroke. Objectives: The aim of this study was firstly, to assess the serum level of vitamin D in cerebral stroke patients and secondly, to examine if its deficiency was associated with stroke severity and outcome. Methods: We utilized a case-control study design and recruited 138 acute stroke patients and 138 age-and sexmatched controls from subjects attending outpatient clinic for other reasons. All participants were subjected to full general and neurological examination. Brain imaging CT and/or MRI was performed. Blood samples were collected for measurement of serum level of vitamin D (ng/ml) by ELISA, alkaline phosphatase, serum calcium, and phosphorous. The stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was assessed by modified Rankin Scale (mRS). Results: Stroke patients had significant lower levels of vitamin D compared with the control group. Vitamin D deficiency remained significantly associated with the NIHSS stroke severity score and the mRS 3-month stroke outcome after controlling for other significant factors such as age, dyslipidemia, and infarction size using multivariable logistic regression analysis. Conclusion: Our results demonstrated that stroke patients suffer from vitamin D deficiency, which was associated with both stroke severity and poor outcome. Vitamin D supplementation could exert a therapeutic role in the management of cerebral stroke.

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Status of Vitamin D and its Association with Stroke Risk Factors in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital

Cited by 10 publications

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The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Serum vitamin D levels in acute stroke patients

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