We aimed to evaluate the association between 25-hydroxyvitamin D [25(OH) D] levels and both clinical severity at admission and outcome at discharge in patients with acute ischemic stroke (AIS). From June 2012 to October 2013, consecutive first-ever AIS patients admitted to the Department of Emergency of The Fourth Affiliated Hospital of Harbin Medical University, China were identified. Clinical information was collected. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated at discharge using the modified Rankin scale (m-Rankin). Multivariate analyses were performed using logistic regression models. During the study period, 326 patients were diagnosed as AIS and were included in the analysis. Serum 25(OH) D levels reduced with increasing severity of stroke as defined by the NIHSS score. There was a negative correlation between levels of 25(OH) D and the NIHSS (r = − 0.389, P = 0.000). In multivariate analyses, serum 25(OH) D level was an independent prognostic marker of discharge favorable functional outcome and survival [odds ratio 3.96 (2.85–7.87) and 3.36 (2.12–7.08), respectively, P = 0.000 for both, adjusted for NHISS, other predictors and vascular risk factors] in patients with AIS. Serum 25(OH) D levels are a predictor of both severity at admission and favorable functional outcome in patients with AIS. Additional research is needed on vitamin D supplementation to improve the outcome of post-stroke patients.
25-Hydroxyvitamin D Acute ischemic stroke Prognosis
This is a preview of subscription content, log in to check access.
We thank all the patients, nurses, and physicians who participated in this study and thereby made this work possible. All authors have contributed significantly, and that all authors are in agreement with the content of the manuscript.
Wang ZY, Sun ZR, Zhang LM (2014) The relationship between serum mannose-binding lectin levels and acute ischemic stroke risk. Neurochem Res 39(2):248–253PubMedCrossRefGoogle Scholar
Witham MD, Dove FJ, Sugden JA et al (2012) The effect of vitamin D replacement on markers of vascular health in stroke patients–A randomised controlled trial. Nutr Metab Cardiovasc Dis 22(10):864–870PubMedCrossRefGoogle Scholar
Rigby WF, Denome S, Fanger MW (1987) Regulation of lymphokine production and human T lymphocyte activation by 1, 25-dihydroxyvitamin D3: specific inhibition at the level of messenger RNA. J Clin Invest 79:1659–1664PubMedCentralPubMedCrossRefGoogle Scholar
Aihara K, Azuma H, Akaike M et al (2004) Disruption of nuclear vitamin D receptor gene causes enhanced thrombogenicity in mice. J Biol Chem 279:35798–35802PubMedCrossRefGoogle Scholar
McGreevy C, Williams D (2011) New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med 155:820–826PubMedCrossRefGoogle Scholar
Michos ED, Reis JP, Post WS et al (2012) 25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: the NHANES-III linked mortality files. Nutrition 28(4):367–371PubMedCentralPubMedCrossRefGoogle Scholar
Brøndum-Jacobsen P, Nordestgaard BG, Schnohr P et al (2013) 25-Hydroxyvitamin D and symptomatic ischemic stroke: an original study and meta-analysis. Ann Neurol 73(1):38–47PubMedCrossRefGoogle Scholar
Daubail B, Jacquin A, Guilland JC et al (2013) Serum 25-hydroxyvitamin D predicts severity and prognosis in stroke patients. Eur J Neurol 20(1):57–61PubMedCrossRefGoogle Scholar
Adams HP, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke 24:35–41PubMedCrossRefGoogle Scholar
Bamford J, Sandercock P, Dennis M et al (1991) Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 337:1521–1526PubMedCrossRefGoogle Scholar
Brott T, Adams HP Jr, Olinger CP et al (1989) Measurements of acute cerebral infarction: a clinical examination scale. Stroke 20:864–870PubMedCrossRefGoogle Scholar
Tu WJ, Zhao SJ, Xu DJ et al (2014) Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischaemic stroke. Clin Sci 126(5):339–346PubMedCrossRefGoogle Scholar
Kalueff AV, Tuohimaa P (2007) Neurosteroid hormone vitamin D and its utility in clinical nutrition. Curr Opin Clin Nutr Metab Care 10:12–19PubMedCrossRefGoogle Scholar
Kajta M, Makarewicz D, Ziemin′ska E et al (2009) Neuroprotection by co-treatment and post-treating with calcitriol following the ischemic and excitotoxic insult in vivo and in vitro. Neurochem Int 55:265–274PubMedCrossRefGoogle Scholar