Serum 25-hydroxyvitamin D predicts early recurrent stroke in ischemic stroke patients

被引:40
作者
Huang, H. [1 ]
Zheng, T. [1 ]
Wang, S. [1 ]
Wei, L. [2 ]
Wang, Q. [2 ]
Sun, Z. [2 ]
机构
[1] Jiao Tong Univ, Branch Peoples Hosp 1, Sch Med, Dept Neurol, Shanghai, Peoples R China
[2] Tongji Univ, East Hosp, Sch Med, Dept Neurosurg, Shanghai, Peoples R China
关键词
25-Hydroxyvitamin D; Stroke recurrence; Ischemic stroke; Chinese; VITAMIN-D SUPPLEMENTATION; LONG-TERM RISK; CARDIOVASCULAR-DISEASE; ATHEROSCLEROSIS RISK; CEREBRAL INFARCTION; VASCULAR EVENTS; INCIDENT STROKE; D DEFICIENCY; METAANALYSIS; PREVENTION;
D O I
10.1016/j.numecd.2016.06.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and aim: This study was conducted to determine 25-hydroxyvitamin D [25(OH) D] levels in serum, and to investigate their associations with stroke recurrence events in a 3-month follow-up study in Chinese patients with first-ever ischemic stroke. Methods and results: From February 2014 to September 2015, consecutive first-ever ischemic stroke patients admitted to the Department of Emergency of our hospital were identified. Serum 25(OH) D levels were measured at admission. We followed the participants for a median of 3 months (range, 2.5-3.5 months) using a standard questionnaire. We used logistic regression models to assess the relationship between 25(OH) levels and risk of recurrent stroke. In this study, 349 ischemic stroke patients were included and completed follow-up. Thirty-seven patients (10.6%) had a stroke recurrence. Serum 25(OH) D levels in patients with recurrent stroke were significantly lower as compared with those in patients without recurrent stroke [9.9 (IQR, 7.9-14.8) ng/mL vs. 17.9 (IQR, 13.4-23.4) ng/mL; P < 0.001). After adjusting for traditional risk factors, serum 25(OH) D levels were negatively associated with the stroke recurrence (OR, 0.897; 95% CI, 0.848-0.950; P < 0.001). Compared with the first quartile of serum 25(OH) D levels, the second quartile OR for recurrent stroke was 0.466 (95% CI, 0.308-707; P = 0.006). For the third and fourth quartiles, it was 0.248 (95% CI, 0.100-0.618; P = 0.001) and 0.173 (95% CI, 0.062-0.482; P < 0.001), respectively. Conclusions: Our findings suggest that reduced serum levels of 25(OH) D can predict the risk of early stroke recurrence in patients with first-ever ischemic stroke. (C) 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:908 / 914
页数:7
相关论文
共 39 条
[1]   Long-Term Mortality After First-Ever and Recurrent Stroke in Young Adults [J].
Aarnio, Karoliina ;
Haapaniemi, Elena ;
Melkas, Susanna ;
Kaste, Markku ;
Tatlisumak, Turgut ;
Putaala, Jukka .
STROKE, 2014, 45 (09) :2670-+
[2]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[3]   CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION [J].
BAMFORD, J ;
SANDERCOCK, P ;
DENNIS, M ;
BURN, J ;
WARLOW, C .
LANCET, 1991, 337 (8756) :1521-1526
[4]   The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis [J].
Bolland, Mark J. ;
Grey, Andrew ;
Gamble, Greg D. ;
Reid, Ian R. .
LANCET DIABETES & ENDOCRINOLOGY, 2014, 2 (04) :307-320
[5]   25-Hydroxyvitamin D and Symptomatic Ischemic Stroke: An Original Study and Meta-Analysis [J].
Brondum-Jacobsen, Peter ;
Nordestgaard, Borge G. ;
Schnohr, Peter ;
Benn, Marianne .
ANNALS OF NEUROLOGY, 2013, 73 (01) :38-47
[6]   MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE [J].
BROTT, T ;
ADAMS, HP ;
OLINGER, CP ;
MARLER, JR ;
BARSAN, WG ;
BILLER, J ;
SPILKER, J ;
HOLLERAN, R ;
EBERLE, R ;
HERTZBERG, V ;
RORICK, M ;
MOOMAW, CJ ;
WALKER, M .
STROKE, 1989, 20 (07) :864-870
[7]   High free fatty acid level is associated with recurrent stroke in cardioembolic stroke patients [J].
Choi, Jeong-Yoon ;
Kim, Ji-Sun ;
Kim, Ji Hyun ;
Oh, Kyungmi ;
Koh, Seong-Beom ;
Seo, Woo-Keun .
NEUROLOGY, 2014, 82 (13) :1142-1148
[8]   Association between Serum Concentration of Vitamin D and 1-Year Mortality in Stroke Patients [J].
Daubail, Benoit ;
Jacquin, Agnes ;
Guilland, Jean-Claude ;
Khoumri, Catia ;
Aboa-Eboule, Corine ;
Giroud, Maurice ;
Bejot, Yannick .
CEREBROVASCULAR DISEASES, 2014, 37 (05) :364-367
[9]   Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis [J].
Ford, John A. ;
MacLennan, Graeme S. ;
Avenell, Alison ;
Bolland, Mark ;
Grey, Andrew ;
Witham, Miles .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2014, 100 (03) :746-755
[10]   Trends in risk of recurrence after the first ischemic stroke in adults younger than 55 years of age in Sweden [J].
Giang, Kok Wai ;
Bjorck, Lena ;
Stahl, Christina H. ;
Nielsen, Susanne ;
Sandstrom, Tatiana Z. ;
Jern, Christina ;
Toren, Kjell ;
Rosengren, Annika .
INTERNATIONAL JOURNAL OF STROKE, 2016, 11 (01) :52-61