Abstract
IntroductionLow serum vitamin D levels are associated with the development of poststroke depression (PSD). Inflammatory markers play an important role in pathophysiology of PSD. The relationship between vitamin D levels and inflammatory markers has been discussed in nonstroke individuals. The purposes of this study were to explore the relationship between vitamin D levels and inflammatory markers in acute stroke patients and examine the effect of vitamin D and inflammatory markers on PSD.MethodsA total of 152 acute stroke patients were recruited. Serum levels of 25‐hydroxyvitamin D and inflammatory markers were measured by standardized laboratory methods. Depression symptoms were assessed with the 17‐item Hamilton Depression Scale (HAMD‐17). Patients with the HAMD‐17 scores ≥7 were identified to have depression symptoms.ResultsSerum vitamin D levels were negatively correlated with serum levels of interleukin‐6 and high‐sensitivity C‐reactive protein (hsCRP) (r = −.244, p = .002; r = −.231, p = .004). Multiple regression analysis showed that interleukin‐6 and hsCRP levels were associated with vitamin D levels (B = −0.355, p = .003; B = −2.085, p = .006), whereas age, height, weight, leukocyte count, neutrophil ratio, and lymphocyte rate could be omitted without changing the results. In multivariate analyses, the serum levels of vitamin D and interleukin‐6 were associated with the development of PSD after adjusted possible variables (OR = 0.976, 95% CI: 0.958–0.994, p = .009; OR = 1.029, 95% CI: 1.003–1.055, p = .027).ConclusionsSerum vitamin D levels are inversely associated with the levels of interleukin‐6 and hsCRP, suggesting a potential anti‐inflammatory role for vitamin D in stroke individuals.
Highlights
Low serum vitamin D levels are associated with the development of poststroke depression (PSD)
This is the first study to assess the relationship between serum vitamin D levels and inflammatory makers including high-sensitivity C-reactive protein (hsCRP), leukocyte count, neutrophil-to-lymphocyte ratio, IL-6 and tumor necrosis factor-α (TNF-α) in acute stroke patients
We found that serum vitamin D levels were inversely associated with the serum IL-6 levels in acute stroke patients
Summary
Vitamin D is a kind of micronutrient which is well known for its key role in musculoskeletal health and calcium homeostasis (Freyschuss, Ljunggren, Saaf, Mellstrom, & Avenell, 2007). Low levels of vitamin D have been found to be associated with increased cardiovascular mortality (Holick, 2011), cancer incidence and mortality (Tagliabue, Raimondi, & Gandini, 2015), and autoimmune diseases such as multiple sclerosis (Alharbi, 2015), probably caused by its anti-inflammatory and immune-modulating properties. Researchers have demonstrated that low levels of vitamin D were associated with the development of poststroke depression (PSD) (Kaloglu et al, 2016) and the underlying mechanism is probably involved in its anti-inflammatory and immune-modulating effects (Han, Lyu, Sun, Wei, & He, 2015). Given the anti-inflammatory profile of vitamin D and its effect on development of PSD, we assessed whether serum vitamin D levels were inversely associated with the blood concentration of inflammatory markers in acute stroke patients and examined the effect of vitamin D and inflammatory markers on PSD
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