The First Clinical Medical College, Nanchang University, Nanchang, China.
The First Clinical Medical College, Nanchang University, Nanchang, China
Biosci Rep. 2018 Mar 5;38(2). doi: 10.1042/BSR20171509. Print 2018 Apr 27.
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.
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。