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Erschienen in: The journal of nutrition, health & aging 8/2017

26.11.2016

Low serum levels of 25-hydroxyvitamin D are associated with stroke recurrence and poor functional outcomes in patients with ischemic stroke

verfasst von: W. Ji, H. Zhou, S. Wang, L. Cheng, Yan Fang

Erschienen in: The journal of nutrition, health & aging | Ausgabe 8/2017

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Abstract

Objective

To evaluate the association between serum 25(OH) D levels and functional outcome and stroke recurrence events in a 6-month follow-up study in a cohort of patients with an acute ischemic stroke (AIS).

Methods

From March 2014 to August 2015, consecutive first-ever AIS patients admitted to the Department of Emergency of our hospital were identified. Serum 25(OH) D levels were measured at admission. Functional outcome was evaluated at 6-month using the modified Rankin scale (m-Rankin). We used logistic regression models to assess the relationship between 25(OH) levels and risk of recurrent stroke or functional outcome.

Results

We recorded 277 stroke patients. There were significantly negative correlation between levels of 25(OH) D and NHISS (P<0.001), and the infarct volume (P< 0.001). Thirty-one patients (11.9%) had a stroke recurrence, while 82 patients (29.6) were with poor functional outcomes. In multivariate logistic regression analyses, serum 25(OH) D level was an independent marker of poor functional outcome and stroke recurrence [odds ratio (OR) 2.55 (1.38-3.96) and 3.03(1.65–4.12), respectively, P<0.001 for both, adjusted for NHISS, other predictors and vascular risk factors] in patients with AIS.

Conclusion

Our results demonstrate that low 25(OH) D levels are associated with stroke recurrence and support the hypothesis that 25(OH) D may serve as a biomarker of poor functional outcome after stroke.
Literatur
1.
Zurück zum Zitat Wang Y, Ji H, Tong Y, et al. Prognostic value of serum 25-hydroxyvitamin D in patients with stroke. Neurochemical research 2014; 39(7): 7–1332. Wang Y, Ji H, Tong Y, et al. Prognostic value of serum 25-hydroxyvitamin D in patients with stroke. Neurochemical research 2014; 39(7): 7–1332.
2.
Zurück zum Zitat Tu W J, Zhao S J, Xu D J, et al. Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischemic stroke. Clinical Science 2014; 126(5): 5–339.CrossRef Tu W J, Zhao S J, Xu D J, et al. Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischemic stroke. Clinical Science 2014; 126(5): 5–339.CrossRef
3.
Zurück zum Zitat Littlejohns TJ, Kos K, Henley WE, et al. Vitamin D and Dementia. J Prev Alz Dis 2016; 3(1):1–43. Littlejohns TJ, Kos K, Henley WE, et al. Vitamin D and Dementia. J Prev Alz Dis 2016; 3(1):1–43.
4.
Zurück zum Zitat Lee S, Teschemaker AR, Daniel M, et al. Calcium and Vitamin D Use among Older Adults in U.S.: Results from National Survey. J Nutr Health Aging 2016; 20(3):3–300.CrossRef Lee S, Teschemaker AR, Daniel M, et al. Calcium and Vitamin D Use among Older Adults in U.S.: Results from National Survey. J Nutr Health Aging 2016; 20(3):3–300.CrossRef
5.
Zurück zum Zitat Sun Q, Pan A, Hu F B, et al. 25-hydroxyvitamin D levels and the risk of stroke a prospective study and meta-analysis. Stroke 2012; 43(6): 6–1470.CrossRef Sun Q, Pan A, Hu F B, et al. 25-hydroxyvitamin D levels and the risk of stroke a prospective study and meta-analysis. Stroke 2012; 43(6): 6–1470.CrossRef
6.
Zurück zum Zitat Kojima G, Bell C, Abbott R D, et al. Low dietary vitamin D predicts 34-year incident stroke the Honolulu heart program. Stroke, 2012, 43(8): 8–2163.CrossRef Kojima G, Bell C, Abbott R D, et al. Low dietary vitamin D predicts 34-year incident stroke the Honolulu heart program. Stroke, 2012, 43(8): 8–2163.CrossRef
7.
Zurück zum Zitat Brøndum-Jacobsen P, Nordestgaard B G, Schnohr P, et al. 25-Hydroxyvitamin D and symptomatic ischemic stroke: An Original Study and Meta-Analysis. Annals of neurology, 2013, 73(1): 1–38.CrossRef Brøndum-Jacobsen P, Nordestgaard B G, Schnohr P, et al. 25-Hydroxyvitamin D and symptomatic ischemic stroke: An Original Study and Meta-Analysis. Annals of neurology, 2013, 73(1): 1–38.CrossRef
8.
Zurück zum Zitat Daubail B, Jacquin A, Guilland J C, et al. Association between serum concentration of vitamin D and 1-year mortality in stroke patients. Cerebrovascular Diseases 2014; 37(5): 5–364.CrossRef Daubail B, Jacquin A, Guilland J C, et al. Association between serum concentration of vitamin D and 1-year mortality in stroke patients. Cerebrovascular Diseases 2014; 37(5): 5–364.CrossRef
9.
Zurück zum Zitat Daumas A, Daubail B, Legris N, et al. Association between Admission Serum 25-Hydroxyvitamin D Levels and Functional Outcome of Thrombolyzed Stroke Patients. Journal of Stroke and Cerebrovascular Diseases, 2016, 25(4): 4–907.CrossRef Daumas A, Daubail B, Legris N, et al. Association between Admission Serum 25-Hydroxyvitamin D Levels and Functional Outcome of Thrombolyzed Stroke Patients. Journal of Stroke and Cerebrovascular Diseases, 2016, 25(4): 4–907.CrossRef
10.
Zurück zum Zitat Park K Y, Chung P W, Kim Y B, et al. Serum vitamin D status as a predictor of prognosis in patients with acute ischemic stroke. Cerebrovascular Diseases, 2015, 40(1-2): 73–80.CrossRefPubMed Park K Y, Chung P W, Kim Y B, et al. Serum vitamin D status as a predictor of prognosis in patients with acute ischemic stroke. Cerebrovascular Diseases, 2015, 40(1-2): 73–80.CrossRefPubMed
11.
Zurück zum Zitat Adams HP Jr, Bendixen BH, Kappelle LJ, et al. 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 1993; 24:35–41. Adams HP Jr, Bendixen BH, Kappelle LJ, et al. 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 1993; 24:35–41.
12.
Zurück zum Zitat Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991; 337:1521–1526.CrossRefPubMed Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991; 337:1521–1526.CrossRefPubMed
13.
Zurück zum Zitat Sims, JR, Gharai, LR, Schaefer, PW, Vangel M, Rosenthal ES. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology 2009; 72:2104–2110.CrossRefPubMedPubMedCentral Sims, JR, Gharai, LR, Schaefer, PW, Vangel M, Rosenthal ES. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology 2009; 72:2104–2110.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Schneider AL, Lutsey PL, Selvin E, et al. Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. European Journal of Neurology, 2015, 22(8): 8–1220.CrossRef Schneider AL, Lutsey PL, Selvin E, et al. Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. European Journal of Neurology, 2015, 22(8): 8–1220.CrossRef
15.
Zurück zum Zitat Coutts S B, Modi J, Patel S K, et al. CT/CT Angiography and MRI Findings Predict Recurrent Stroke After Transient Ischemic Attack and Minor Stroke Results of the Prospective CATCH Study. Stroke, 2012, 43(4): 4–1013.CrossRef Coutts S B, Modi J, Patel S K, et al. CT/CT Angiography and MRI Findings Predict Recurrent Stroke After Transient Ischemic Attack and Minor Stroke Results of the Prospective CATCH Study. Stroke, 2012, 43(4): 4–1013.CrossRef
16.
Zurück zum Zitat Kwon SU, Hong KS, Kang DW, Park JM, Lee JH, Cho YJ, et al. Efficacy and safety of combination antiplatelet therapies in patients with symptomatic intracranial atherosclerotic stenosis. Stroke. 2011; 42:2883–2890.CrossRefPubMed Kwon SU, Hong KS, Kang DW, Park JM, Lee JH, Cho YJ, et al. Efficacy and safety of combination antiplatelet therapies in patients with symptomatic intracranial atherosclerotic stenosis. Stroke. 2011; 42:2883–2890.CrossRefPubMed
17.
Zurück zum Zitat Howard G, Kissela B M, Kleindorfer D O, et al. Differences in the role of black race and stroke risk factors for first vs recurrent stroke. Neurology, 2016: 10.1212/WNL.0000000000002376. Howard G, Kissela B M, Kleindorfer D O, et al. Differences in the role of black race and stroke risk factors for first vs recurrent stroke. Neurology, 2016: 10.1212/WNL.0000000000002376.
18.
Zurück zum Zitat Aarnio K, Haapaniemi E, Melkas S, et al. Long-term mortality after first-ever and recurrent stroke in young adults. Stroke, 2014, 45(9): 9–2670.CrossRef Aarnio K, Haapaniemi E, Melkas S, et al. Long-term mortality after first-ever and recurrent stroke in young adults. Stroke, 2014, 45(9): 9–2670.CrossRef
19.
Zurück zum Zitat Giang K W, Björck L, Ståhl C H, et al. Trends in risk of recurrence after the first ischemic stroke in adults younger than 55 years of age in Sweden. International Journal of Stroke, 2016, 11(1): 1–52.CrossRef Giang K W, Björck L, Ståhl C H, et al. Trends in risk of recurrence after the first ischemic stroke in adults younger than 55 years of age in Sweden. International Journal of Stroke, 2016, 11(1): 1–52.CrossRef
20.
Zurück zum Zitat Wang Y, Xu J, Zhao X, et al. Association of hypertension with stroke recurrence depends on ischemic stroke subtype. Stroke, 2013, 44(5): 5–1232CrossRef Wang Y, Xu J, Zhao X, et al. Association of hypertension with stroke recurrence depends on ischemic stroke subtype. Stroke, 2013, 44(5): 5–1232CrossRef
21.
Zurück zum Zitat Oliai Araghi S, van Dijk SC, Ham AC, et al. BMI and Body Fat Mass Is Inversely Associated with Vitamin D Levels in Older Individuals. J Nutr Health Aging 2015; 19(10):10–980.CrossRef Oliai Araghi S, van Dijk SC, Ham AC, et al. BMI and Body Fat Mass Is Inversely Associated with Vitamin D Levels in Older Individuals. J Nutr Health Aging 2015; 19(10):10–980.CrossRef
22.
Zurück zum Zitat Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012; 5:819–829.CrossRefPubMedPubMedCentral Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012; 5:819–829.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Welles CC, Whooley MA, Karumanchi SA, et al. Vitamin D deficiency and cardiovascular events in patients with coronary heart disease: data from the Heart and Soul Study. American journal of epidemiology, 2014, 179(11): 11–1279. Welles CC, Whooley MA, Karumanchi SA, et al. Vitamin D deficiency and cardiovascular events in patients with coronary heart disease: data from the Heart and Soul Study. American journal of epidemiology, 2014, 179(11): 11–1279.
24.
Zurück zum Zitat Vinh Quôc Luong K, Thi Hoàng Nguyên L. Vitamin D and Parkinson’s disease. J Neurosci Res 2012; 90:2227–36CrossRefPubMed Vinh Quôc Luong K, Thi Hoàng Nguyên L. Vitamin D and Parkinson’s disease. J Neurosci Res 2012; 90:2227–36CrossRefPubMed
25.
Zurück zum Zitat Pilz S, Tomaschitz A, Drechsler C, et al. Vitamin D supplementation: a promising approach for the prevention and treatment of strokes. Curr Drug Targets 2011; 12(1):1–88.CrossRef Pilz S, Tomaschitz A, Drechsler C, et al. Vitamin D supplementation: a promising approach for the prevention and treatment of strokes. Curr Drug Targets 2011; 12(1):1–88.CrossRef
26.
Zurück zum Zitat Bobryshev YV. Vitamin D3 suppresses immune reactions in atherosclerosis, affecting regulatory T cells and dendritic cell function. Arterioscler Thromb Vasc Biol 2010; 30:2317–2319.CrossRefPubMed Bobryshev YV. Vitamin D3 suppresses immune reactions in atherosclerosis, affecting regulatory T cells and dendritic cell function. Arterioscler Thromb Vasc Biol 2010; 30:2317–2319.CrossRefPubMed
Metadaten
Titel
Low serum levels of 25-hydroxyvitamin D are associated with stroke recurrence and poor functional outcomes in patients with ischemic stroke
verfasst von
W. Ji
H. Zhou
S. Wang
L. Cheng
Yan Fang
Publikationsdatum
26.11.2016
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 8/2017
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-016-0846-3

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