血清 25-羟维生素 D 水平降低与缺血性脑卒中患者早期神经功能恶化的风险相关。
Decreasing serum 25-hydroxyvitamin D levels and risk of early neurological deterioration in patients with ischemic stroke.
机构信息
Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China.
Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
出版信息
Brain Behav. 2019 Mar;9(3):e01227. doi: 10.1002/brb3.1227. Epub 2019 Feb 6.
BACKGROUND AND AIMS
Vitamin D deficiency has been linked to a higher risk of ischemic stroke. We therefore explored the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and early neurological deterioration (END) after acute ischemic stroke in a hospital-based prospective study.
METHODS
From June 2016 to June 2018, patients with ischemic stroke within 48 hr from symptom onset were consecutively recruited. Serum 25(OH)D levels were measured at admission. END was defined as an increase of ≥1 point in motor power or ≥2 points in the total National Institute of Health Stroke Scale score within 7 days after admission. Multiple logistic regression models were performed to calculate the odds ratio (OR) and confidence intervals (CI) of 25(OH)D levels in predicting END.
RESULTS
A total of 478 subjects were enrolled, of which 136 (28.5%) patients developed END. The mean 25(OH)D levels were 49.5 ± 15.8 nmol/L. Univariate logistic regression analysis showed that advanced age, white matter lesions, high level of body mass index, diastolic blood pressure, fasting blood glucose and homocysteine, and low 25(OH)D levels were associated with END. Furthermore, multivariate regression analysis demonstrated that the first quartile of 25(OH)D concentrations [OR, 2.628; 95% CI,1.223-5.644; p = 0.013] was independently risk factor for END.
CONCLUSIONS
This study illustrated that lower 25(OH)D levels might be associated with an increasing risk of END in acute ischemic stroke patients.
背景与目的
维生素 D 缺乏与缺血性脑卒中风险增加有关。因此，我们在一项基于医院的前瞻性研究中探讨了血清 25-羟维生素 D [25(OH)D]水平与急性缺血性脑卒中后早期神经功能恶化（END）的关系。
方法
从 2016 年 6 月至 2018 年 6 月，连续招募发病 48 小时内的缺血性脑卒中患者。入院时测量血清 25(OH)D 水平。END 定义为入院后 7 天内运动力量增加≥1 分或总国立卫生研究院卒中量表评分增加≥2 分。采用多因素 logistic 回归模型计算 25(OH)D 水平预测 END 的比值比（OR）和置信区间（CI）。
结果
共纳入 478 例患者，其中 136 例（28.5%）患者发生 END。平均 25(OH)D 水平为 49.5±15.8 nmol/L。单因素 logistic 回归分析显示，年龄较大、脑白质病变、较高的体重指数、舒张压、空腹血糖和同型半胱氨酸水平以及较低的 25(OH)D 水平与 END 相关。此外，多因素回归分析表明，25(OH)D 浓度第一四分位数[OR，2.628；95%CI，1.223-5.644；p=0.013]是 END 的独立危险因素。
结论
本研究表明，急性缺血性脑卒中患者较低的 25(OH)D 水平可能与 END 的风险增加有关。
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