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维生素 D 缺乏与非糖尿病缺血性脑卒中患者不良功能结局的关系。

Vitamin D deficiency in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke.

机构信息

The First Clinical Medical College, Nanchang University, Nanchang, China.

The First Clinical Medical College, Nanchang University, Nanchang, China

出版信息

Biosci Rep. 2018 Mar 5;38(2). doi: 10.1042/BSR20171509. Print 2018 Apr 27.

Abstract

To assess the hypothesis that vitamin D, reflected by 25-hydroxyvitamin D (25(OH) D) would be associated with higher risk of poor functional outcomes amongst nondiabetic stroke patients. The present study was conducted in Nanchang, China. Serum concentration of 25(OH) D and National Institutes of Health Stroke Scale (NIHSS) were measured at the time of admission. Functional outcome was measured by modified Rankin scale (mRS) at 1 year after admission. Multivariate analyses were performed using logistic regression models. The cut point of 25(OH) D level for vitamin D deficiency was 20 ng/ml. In the present study, 266 nondiabetic subjects with stroke were included; 149 out of the 266 patients were defined as vitamin D deficiency (56%). The poor outcome distribution across the 25(OH) D quartiles ranged between 64% (first quartile) and 13% (fourth quartile). In those 149 patients with vitamin D deficiency, 75 patients were defined as poor functional outcomes, giving a prevalence rate of 50% (95% confidence interval (CI): 42-58%). In multivariate analysis models, for vitamin D deficiency, the adjusted risk of poor functional outcomes and mortality increased by 220% (odds ratio (OR): 3.2; 95% CI: 1.7-4.2, <0.001) and 290% (OR: 3.9; 95% CI: 2.1-5.8, <0.001), respectively. Vitamin D deficiency is associated with an increased risk of poor functional outcome events in Chinese nondiabetic stroke individuals.

摘要

为了评估维生素 D(通过 25-羟维生素 D [25(OH)D] 来反映)与非糖尿病性卒中患者较差的功能结局风险之间存在关联的假说。本研究在中国南昌进行。入院时测量血清 25(OH)D 浓度和国立卫生研究院卒中量表(NIHSS)。入院 1 年后,通过改良 Rankin 量表(mRS)测量功能结局。使用逻辑回归模型进行多变量分析。25(OH)D 水平的维生素 D 缺乏切点为 20ng/ml。在本研究中,纳入了 266 名非糖尿病性卒中患者;其中 266 例患者中有 149 例被定义为维生素 D 缺乏(56%)。25(OH)D 四分位数的不良结局分布范围在 64%(第一四分位数)至 13%(第四四分位数)之间。在 149 例维生素 D 缺乏的患者中,有 75 例被定义为功能结局较差,患病率为 50%(95%置信区间(CI):42-58%)。在多变量分析模型中,对于维生素 D 缺乏,不良功能结局和死亡的调整风险分别增加了 220%(比值比[OR]:3.2;95%CI:1.7-4.2,<0.001)和 290%(OR:3.9;95%CI:2.1-5.8,<0.001)。维生素 D 缺乏与中国非糖尿病性卒中个体不良功能结局事件的风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc6/5835715/21561119226f/bsr-38-bsr20171509-g1.jpg

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