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Serum 25-hydroxyvitamin D deficiency predicts poor outcome among acute ischemic stroke patients without hypertension
Neurochemistry international ( IF 4.4 ) Pub Date : 2018-05-03
Bingjun Zhang, Yuge Wang, Yi Zhong, Siyuan Liao, Zhengqi Lu

25-Hydroxyvitamin D (25(OH)D) deficiency is a frequent condition in patients who suffer acute ischemic stroke (AIS), and several studies suggested that it may be associated with a poorer prognosis. Whether this association is affected by hypertension is unclear. Our aim was to investigate the association between 25(OH)D levels and both clinical severity and outcome after 3 months in AIS patients stratified by the history of hypertension. Consecutive first-ever AIS patients admitted to the Third Affiliated Hospital of Sun Yat-sen 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 after 3 months of onset using the modified Rankin Scale (mRS). Multivariate analyses were performed using logistic regression models. During the study period, 377 patients were diagnosed as AIS and were included in the analysis. 25(OH)D deficiency was not associated with the risk of NIHSS at admission and 3 months mRS both in total patients and the hypertension subgroup. Among AIS without hypertension, 25(OH)D deficiency subjects had a significantly higher of NIHSS at admission and 3 months mRS compared with those with 25(OH)D ≥ 50 nmol/L. The odds ratios (95% confidence interval) were 5.51(1.83–16.60) and 4.63(1.53–14.05) in the multivariable adjusted model (P for linear trend < 0.05). Serum lower 25(OH)D levels can be seen as an independent prognostic factor of functional outcome in AIS without hypertension. Additional studies about improving prognosis of AIS by vitamin D supplementation could be first applied to these patients.



中文翻译:

血清25-羟维生素D缺乏症可预测无高血压的急性缺血性中风患者的预后不良

25-羟维生素D(25(OH)D)缺乏症是患有急性缺血性中风(AIS)的患者的常见病,一些研究表明,它可能与较差的预后有关。尚不清楚这种关联是否受到高血压的影响。我们的目的是调查按高血压病史分层的AIS患者3个月后25(OH)D水平与临床严重程度和预后之间的关系。确定了连续入院的中山大学附属第三医院。收集临床信息。在基线时测量血清25(OH)D水平。入院时使用美国国立卫生研究院卒中量表(NIHSS)评分评估卒中严重程度。发病3个月后,使用改良的兰金量表(mRS)评估功能结局。使用逻辑回归模型进行多变量分析。在研究期间,有377名患者被诊断为AIS,并被纳入分析。在总患者和高血压亚组中,25(OH)D缺乏与入院时NIHSS和3个月mRS的风险无关。在没有高血压的AIS中,与25(OH)D≥50 nmol / L的患者相比,25(OH)D缺乏症患者入院时和3个月mRS中的NIHSS显着更高。在多变量调整模型中,比值比(95%置信区间)为5.51(1.83–16.60)和4.63(1.53–14.05)(线性趋势<0.05的P)。血清较低的25(OH)D水平可被视为无高血压的AIS功能预后的独立预后因素。

更新日期:2018-05-04
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