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小血管和大血管缺血性中风患者的维生素D状况:一项病例对照研究。

Vitamin D Status in Small Vessel and Large Vessel Ischemic Stroke Patients: A Case-control Study.

作者信息

Manouchehri Navid, Vakil-Asadollahi Maryam, Zandifar Alireza, Rasmani Fereshteh, Saadatnia Mohammad

机构信息

Medical Students' Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2017 Nov 30;6:146. doi: 10.4103/2277-9175.219411. eCollection 2017.

Abstract

BACKGROUND

Vitamin D insufficiency is a globally widespread issue. Recent studies have reported a high prevalence of Vitamin D deficiency in Middle-East countries. Studies have shown negative effects of Vitamin D deficiency on endothelium and related diseases such as ischemic brain stroke. Here, we assessed Vitamin D status in patients with different types of ischemic brain stroke and control group.

MATERIALS AND METHODS

Seventy-five patients (49.3% small vessel, 50.7% large vessel) and 75 controls, matched for age (68.01 ± 10.94 vs. 67.64 ± 10.24) and sex (42 male and 33 female) were recruited. 25(OH) D levels were measured by Chemiluminescence immunoassay. 25(OH) D status was considered as severely, moderately, or mildly deficient and normal with 25(OH) D levels of less than 5, 5-10, 10-16, and >16 ng/ml, respectively.

RESULTS

Mean ± standard error concentration of 25(OH) D in cases and controls were 17.7 ± 1.5 and 26.9 ± 1.6 ( = 0.0001), respectively. Mild, moderate, and severe Vitamin D deficiency were observed in 10.8%, 32.4%, 8.1% vs. 34.3%, 31.5%, 9.5% of small vessel and large vessel group, respectively. 21.7% of the controls were Vitamin D deficient. Vitamin D deficiency was significantly associated with higher risk for ischemic stroke, ( = 0.000, OR = 7.17, 95% confidence interval: 3.36-15.29). 25(OH) D levels were significantly higher in control group comparing to small vessel (26.9 ± 1.6 vs. 20.59 ± 2.6 < 0.05) and large vessel (26.9 ± 1.6 vs. 13.4 ± 1.3 < 0.001) stroke patients. Small vessel group had significantly higher levels of Vitamin D than large vessel ( < 0.05).

CONCLUSION

Vitamin D deficiency significantly increases the risk of ischemic stroke, favoring the types with the pathogenesis of large vessel strokes.

摘要

背景

维生素D不足是一个全球普遍存在的问题。最近的研究报告称中东国家维生素D缺乏的患病率很高。研究表明维生素D缺乏对内皮及相关疾病如缺血性脑卒中有负面影响。在此,我们评估了不同类型缺血性脑卒中患者及对照组的维生素D状况。

材料与方法

招募了75例患者(49.3%为小血管性,50.7%为大血管性)和75名对照者,年龄(68.01±10.94岁 vs. 67.64±10.24岁)和性别(42名男性和33名女性)相匹配。采用化学发光免疫分析法测量25(OH)D水平。25(OH)D状况被认为严重、中度或轻度缺乏以及正常,其25(OH)D水平分别低于5、5 - 10、10 - 16和>16 ng/ml。

结果

病例组和对照组25(OH)D的平均±标准误浓度分别为17.7±1.5和26.9±1.6(P = 0.0001)。小血管组和大血管组中轻度、中度和重度维生素D缺乏分别为10.8%、32.4%、8.1% vs. 34.3%、31.5%、9.5%。21.7%的对照者维生素D缺乏。维生素D缺乏与缺血性脑卒中的较高风险显著相关(P = 0.000,OR = 7.17,95%置信区间:3.36 - 15.29)。与小血管性(26.9±1.6 vs. 20.59±2.6,P < 0.05)和大血管性(26.9±1.6 vs. 13.4±1.3,P < 0.001)脑卒中患者相比,对照组的25(OH)D水平显著更高。小血管组的维生素D水平显著高于大血管组(P < 0.05)。

结论

维生素D缺乏显著增加缺血性脑卒中风险,更倾向于大血管性脑卒中发病机制类型。

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