Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study.

Hanpei Miao,Hanyu Zhu,Xiaoqian Luan,Meixia Chen,Guiqian Huang,Zhen Wang,Zhengzhong Yuan

doi:10.3389/fnagi.2020.613498

Abstract

PurposeLower serum vitamin D has been reported to be associated with stroke. This study aimed to analyze the risk factors of vitamin deficiency in Chinese stroke patients, and further analyze its impact in different gender and their clinical variables.Methods982 stroke patients were enrolled. Laboratory parameters such as serum vitamin D, apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB), ApoA-I/ApoB, cholesterol (CH), fibrinogen (FIB), blood glucose (Glu), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were collected and recorded. The severity of stroke was assessed by National Institute of Health Stroke Scale (NIHSS) score. Based on their serum vitamin D level, patients were divided into three groups: Vitamin D deficiency (<50 nmol/L), vitamin D insufficiency (≥50–75 nmol/L) and vitamin D sufficiency (≥75 nmol/L) and differences were compared among the three groups. Statistical analyses were done to assess the risk factors for serum vitamin D deficiency in our ischemic stroke patients.ResultsGender, NIHSS, and FIB showed significant differences among the vitamin D groups (P < 0.001 ∼ P = 0.002). The female gender (OR = 2.422, P < 0.001), severity of stroke using NIHSS (OR = 1.055, P = 0.008) and FIB (OR = 1.256, P = 0.005) were risk factors of vitamin D deficiency in ischemic stroke patients. In subgroup analysis, NIHSS was significantly associated with vitamin D deficiency in the male group (OR = 1.087, P = 0.002) and higher FIB group (OR = 1.078, P = 0.001).ConclusionsThe female gender, severity of stroke using NIHSS and FIB were risk factors for vitamin D deficiency in our incident stroke patients. NIHSS was more sensitive to vitamin D deficiency in male ischemic stroke patients. Besides, under higher FIB circumstance, the increasing NIHSS score was more related to the vitamin D deficiency. Levels of vitamin D in patients with ischemic stroke should be well monitored during the disease cascade.

Highlights

Recent reports have shown a major rise in the aging population worldwide especially in China, the country with the largest population
In a univariate linear regression analysis, age, SBP, DBP, vitamin D, apolipoprotein B (ApoB), apolipoprotein A-I (ApoA-I)/ApoB, FIB low-density lipoprotein cholesterol (LDL-C), and TG were significantly associated to National Institute of Health Stroke Scale (NIHSS) (P < 0.001 ∼ 0.049; Table 2), respectively
The cutoff values for deficiency in vitamin D used in previous reports vary, our current report suggests less than 50 nmol/L used in the Chinese population may be of significance in the clinical field and a sufficient level of 75 nmol/L may be ideal for health benefits which is congruent with a previous report (Holick et al, 2011)

Summary

Introduction

Recent reports have shown a major rise in the aging population worldwide especially in China, the country with the largest population. China has experienced rapid changes in their sociodemographic and health transitions have shown a significant impact on the prevalence of risk factors associated with stroke (Yang et al, 2013). Statistics have shown that there’s been a significant rise in the occurrence of smoking, hypertension and diabetes, all of which have been reported to be risk factors for stroke (Feigin et al, 2016). With these rapid changes in China, it would be helpful to obtain an up to date and accurate risk factor(s) to help in the recently implemented therapies and prevention measures

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