Vitamin D deficiency is associated with acute ischemic stroke, C-reactive protein, and short-term outcome

Abstract

The aim of this study was to investigate whether vitamin D deficiency (VDD) is associated with acute ischemic stroke, inflammatory markers, and short-term outcome. 168 acute ischemic stroke patients and 118 controls were included. The modified Rankin Scale (mRS) was applied up to 8 h of admission (baseline) and after three-months follow-up, and blood samples were obtained up to 24 h of admission to evaluate serum levels of 25-hydroxivitamin D [25(OH)D] and inflammatory markers. Vitamin D levels classified the individuals in sufficient (VDS ≥ 30.0 ng/mL), insufficient (VDI 20.0-29.9 ng/mL), and deficient (VDD < 20.0 ng/mL) status. Patients had lower levels of 25(OH)D, higher frequency of VDD (43.45% vs. 5.08%, OR: 16.64, 95% CI: 5.66-42.92, p < 0.001), and higher inflammatory markers than controls (p < 0.05). Patients with VDD showed increased high sensitivity C-reactive protein (hsCRP) levels than those with VDS status (p = 0.043); those with poor outcome presented with lower 25(OH)D levels than those with good outcome (p = 0.008); moreover, 25(OH)D levels were negatively correlated with mRS after three-months follow-up (r = -0.239, p = 0.005). The associations between VDD and higher hsCRP levels and between 25(OH)D levels and poor outcome at short-term in acute ischemic stroke patients suggest the important role of vitamin D in the inflammatory response and pathophysiology of this ischemic event.

Vitamin D: Way More Important in Critical Care Than We May Have Recognized

“…51 Patients with ischemic stroke had lower levels of vitamin D, higher prevalence of VDD, and higher high-sensitivity C-reactive protein than controls. Three months later, stroke patients with poor outcomes had lower VDD levels than those with good outcomes, suggesting that vitamin D has an important role in the inflammatory response, pathophysiology, and recovery from acute ischemic stroke.…”

“…Three months later, stroke patients with poor outcomes had lower VDD levels than those with good outcomes, suggesting that vitamin D has an important role in the inflammatory response, pathophysiology, and recovery from acute ischemic stroke. 51 Increased Immune Dysfunction: Inflammation, Infection, and Sepsis…”

Vitamin D and Its Role in Neonatal Hypoxic-Ischemic Brain Injury

“…Vitamin D deficiency not only creates a lack of anti-inflammatory benefits but may even result in an increased inflammatory response, resulting in secondary injury to neurons [9]. For instance, calcitriol has been shown to downregulate the expression of the proinflammatory cytokines TNF-α, IL-6, and IFN-γ [10, 11], in part by preventing the action of Th1 cells that leads to the release of the inflammatory cytokines.…”

“…For instance, calcitriol has been shown to downregulate the expression of the proinflammatory cytokines TNF-α, IL-6, and IFN-γ [10, 11], in part by preventing the action of Th1 cells that leads to the release of the inflammatory cytokines. At the same time, Treg and Th2 cells that produce anti-inflammatory cytokines are upregulated by the presence of vitamin D [9]. When assessing brain inflammation specifically, mice treated with calcitriol demonstrated increased levels of anti-inflammatory IL-4 and TGF-β1 [51].…”

“…In addition to direct effects on VDRs, vitamin D also regulates calcium [8] and inflammatory cytokines [9-11]. In adults, vitamin D deficiency has been associated with the development and severity of ischemic stroke [9].…”