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维生素 D 状态与急性缺血性脑卒中患者认知障碍的相关性:一项前瞻性队列研究。

Association between vitamin D status and cognitive impairment in acute ischemic stroke patients: a prospective cohort study.

机构信息

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China,

Department of Mental Health, Mental Health School, Wenzhou Medical University, Wenzhou 325000, China.

出版信息

Clin Interv Aging. 2018 Dec 10;13:2503-2509. doi: 10.2147/CIA.S187142. eCollection 2018.

Abstract

OBJECTIVE

Previous studies found that low vitamin D levels were modestly associated with risk of stroke and poor functional outcome after stroke. In addition, vitamin D deficiency has been linked with cognitive decline. Our study aimed to explore the potential relationship between vitamin D levels in the short-term acute phase of ischemic stroke and cognitive impairment at 1 month.

METHODS

In total, 354 ischemic stroke patients were consecutively enrolled in the study and received 1-month follow-up. The serum levels of vitamin D were measured within 24 hours after admission. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) at 1 month after acute ischemic stroke. Cognitive impairment was defined according to different education levels.

RESULTS

According to MMSE scores, 114 participants (32.2%) had cognitive impairment at 1 month. Patients with vitamin D deficiency were more likely to have cognitive impairment than those with vitamin D insufficiency and vitamin D sufficiency (<0.001). After adjusting for potential confounders in our Cox proportional hazards model, vitamin D deficiency was independently associated with the development of cognitive impairment in acute ischemic stroke patients.

CONCLUSION

Independent of established risk factors, vitamin D deficiency in the short-term phase of ischemic stroke was associated with a higher incidence of 1-month cognitive impairment.

摘要

目的

既往研究发现,维生素 D 水平较低与中风风险和中风后功能预后不良之间存在一定关联。此外,维生素 D 缺乏与认知能力下降有关。本研究旨在探讨缺血性脑卒中急性期短期维生素 D 水平与 1 个月时认知障碍之间的潜在关系。

方法

本研究连续纳入了 354 例缺血性脑卒中患者,并进行了 1 个月的随访。入院后 24 小时内测量血清维生素 D 水平。急性缺血性脑卒中后 1 个月采用简易精神状态检查(MMSE)评估认知功能。根据不同的教育程度定义认知障碍。

结果

根据 MMSE 评分,114 名患者(32.2%)在 1 个月时存在认知障碍。与维生素 D 不足和维生素 D 充足的患者相比,维生素 D 缺乏的患者更有可能发生认知障碍(<0.001)。在校正我们的 Cox 比例风险模型中的潜在混杂因素后,维生素 D 缺乏与急性缺血性脑卒中患者认知障碍的发生独立相关。

结论

独立于已确定的危险因素,缺血性脑卒中短期阶段的维生素 D 缺乏与 1 个月时认知障碍的发生率升高有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4285/6292227/2ef820b7abc4/cia-13-2503Fig1.jpg

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