Majumdar V, Prabhakar P, Kulkarni G B, Christopher R
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
J Hum Hypertens. 2015 Nov;29(11):669-74. doi: 10.1038/jhh.2015.10. Epub 2015 Mar 26.
The relationship between vitamin D deficiency and stroke was cross-sectionally evaluated in the high-risk Asian Indian population. Age- and gender-matched, 239 ischemic stroke patients and 241 control subjects were recruited. Vitamin D status was estimated by measuring serum 25-hydroxyvitamin D (25(OH)D) levels. After multivariate adjustment for a range of potential covariates in a logistic regression model, an inverse association was found between serum 25(OH)D concentration and risk of ischemic stroke: subjects with severely low 25(OH)D levels (⩽9.33 ng ml(-1)) were found to be at 3.13-fold (95% confidence interval (CI), (1.22-8.07)) increased risk of ischemic stroke as compared with those with high levels. Adjustment for systolic blood pressure levels was found to abrogate this association (odds ratio (OR)=2.00, 95% CI=0.61-6.50). On stratification, a pronounced association was found between low 25(OH)D and risk of ischemic stroke in hypertensives, OR=13.54, 95% CI=1.94-94.43 as compared with no association in non-hypertensives, (Pinteraction=0.04). We conclude that high blood pressure partly explains the association between 25(OH)D levels and ischemic stroke. Presence of hypertension amply aggravates the risk of ischemic stroke associated with low vitamin D levels. Meticulous management of hypertension, regular monitoring of serum 25(OH)D levels and treatment of severe vitamin D deficiency, particularly in hypertensive subjects, could help in effective prevention of stroke.
在高危亚洲印度人群中对维生素D缺乏与中风之间的关系进行了横断面评估。招募了年龄和性别匹配的239例缺血性中风患者和241例对照受试者。通过测量血清25-羟基维生素D（25(OH)D）水平来评估维生素D状态。在逻辑回归模型中对一系列潜在协变量进行多变量调整后，发现血清25(OH)D浓度与缺血性中风风险之间存在负相关：与25(OH)D水平高的受试者相比，25(OH)D水平极低（⩽9.33 ng ml(-1)）的受试者发生缺血性中风的风险增加了3.13倍（95%置信区间（CI），(1.22 - 8.07)）。发现调整收缩压水平可消除这种关联（比值比（OR）=2.00，95% CI = 0.61 - 6.50）。分层分析发现，高血压患者中低25(OH)D与缺血性中风风险之间存在显著关联，OR = 13.54，95% CI = 1.94 - 94.43，而非高血压患者中无此关联，（P交互作用 = 0.04）。我们得出结论，高血压部分解释了25(OH)D水平与缺血性中风之间的关联。高血压的存在显著加剧了与低维生素D水平相关的缺血性中风风险。对高血压进行精心管理、定期监测血清25(OH)D水平以及治疗严重维生素D缺乏，特别是在高血压患者中，可能有助于有效预防中风。
