Abstract
Background and purposePrevious studies have established that vitamin D was associated with stroke. The purpose of this study was to investigate the relationship between vitamin D and 5‐year outcome of patients with stroke including acute ischemic stroke (AIS) and intracranial hemorrhage (ICH) stroke.MethodsSerum 25‐hydroxyvitamin D levels were prospectively analyzed in patients admitted to the First Affiliated Hospital of Wenzhou Medical University from 2013 to 2015. Modified Rankin scale (mRS) was used to evaluate their 5‐year functional outcome, and univariate and multivariate logistic regressions were applied to evaluate the effects of vitamin D on stroke outcome.ResultsIn total, 668 patients diagnosed with stroke were recruited, and 420 completed the 5‐year follow‐up. Ninety‐five patients experienced poor outcome in the 5 years since stroke onset. Vitamin D levels in patients with poor outcome showed significant differences compared to good outcome patients (p < .001). In multivariable logistic regression analysis, after adjusting the potential confounders, the 5‐year functional outcome was significantly associated with vitamin D levels. Stroke patients with vitamin D levels less than 38.4 nmol/L had a higher risk for poor outcome compared with those with vitamin D level over 71.4 nmol/L at 5‐year (odds ratio [OR] = 3.66, 95% confidence interval [CI] = 1.42–9.45, p = .007), which was consistent with AIS patients (OR = 6.36, 95% CI = 1.89–21.44, p = .003).ConclusionVitamin D level less than 38.4 nmol/L at admission is a potential risk biomarker for poor functional outcome at 5‐year prognosis in AIS patients, which might provide new ideas for the prognostic assessment of stroke.
Highlights
Stroke is generally considered as the second leading cause of death and a first leading cause of adult disability worldwide
We defined the Modified Rankin scale (mRS) as a dichotomous variable, an mRS score in the 0–2 range, which indicates no symptoms to a minimal disability, reflects good outcome, whereas the 3–6 range reflects moderate to severe disability or death, reflecting a poor outcome
After 5-month follow-up, 420 samples completed the follow-up data: 270 of them were men, while 150 were women (63.8 ± 9.0 years); note that 350 (83.3%) of the patients presented with acute ischemic stroke (AIS), while the remaining 70 (16.7%) showed intracranial hemorrhage (ICH) at admission; the median National Institute of Health Stroke Scale (NIHSS) score was 3 (1–5) and the mean 25(OH)D levels were 54.6 (38.3–71.5) nmol/L
Summary
Stroke is generally considered as the second leading cause of death and a first leading cause of adult disability worldwide. There is limited research on the relationship between vitamin D and long-term functional outcomes of stroke. In multivariable logistic regression analysis, after adjusting the potential confounders, the 5-year functional outcome was significantly associated with vitamin D levels. Stroke patients with vitamin D levels less than 38.4 nmol/L had a higher risk for poor outcome compared with those with vitamin D level over 71.4 nmol/L at 5-year (odds ratio [OR] = 3.66, 95% confidence interval [CI] = 1.42–9.45, p = .007), which was consistent with AIS patients (OR = 6.36, 95% CI = 1.89–21.44, p = .003). Conclusion: Vitamin D level less than 38.4 nmol/L at admission is a potential risk biomarker for poor functional outcome at 5-year prognosis in AIS patients, which might provide new ideas for the prognostic assessment of stroke
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