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首次缺血性脑卒中患者血清 25-羟维生素 D 水平降低与住院时间延长及血糖稳态改变有关。

Depressed Serum 25-Hydroxyvitamin D Levels Increase Hospital Stay and Alter Glucose Homeostasis in First-ever Ischemic Stroke.

机构信息

Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Neurology, The Affiliated Hospital of Wei Fang Medical University, Weifang, China.

出版信息

Curr Neurovasc Res. 2019;16(4):340-347. doi: 10.2174/1567202616666190924161947.

Abstract

BACKGROUND AND OBJECTIVE

Vitamin D deficiency is internationally recognized among the potentially modifiable risk factors for ischemic cardio-cerebrovascular diseases. However, the association between vitamin D deficiency and stroke morbidity or mortality remains insufficiently known. Our aim is to investigate their relevance to 25-hydroxyvitamin D [25(OH) D] levels and clinical severity and outcome after 3 months in first-ever ischemic stroke.

METHODS

Retrospective analysis of 356 consecutive patients in first-ever ischemic stroke between 2013 and 2015. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome after 3 months of onset was evaluated using the modified Rankin scale (mRS).

RESULTS

Among the 356 enrolled patients, HbA1c was higher in insufficiency/deficiency group than that in the sufficiency group (6.3 ± 1.7 vs. 5.9 ± 1.1, p =0.015). The hospital stay was longer in insufficiency/deficiency group than that in the sufficiency group (11 (8-17) vs. 9.5 (7-13), p = 0.035). There was a significant inversed trend between serum 25(OH) D levels and hospital stay (OR 0.960, P = 0.031), using logistic regression.

CONCLUSION

25(OH)D levels are associated with glucose homeostasis, 25(OH) D contributes to increase the length of hospital stay. Low serum 25-OHD level is an independent predictor for hospital stay in first-ever ischemic stroke. Vitamin D deficiency did not predict functional outcome in the span of 3 months.

摘要

背景与目的

维生素 D 缺乏症是国际公认的缺血性心脑血管疾病潜在可调节危险因素之一。然而,维生素 D 缺乏与中风发病率或死亡率之间的关系尚未得到充分认识。我们旨在研究其与 25-羟维生素 D [25(OH)D]水平及发病后 3 个月内临床严重程度和结局的相关性。

方法

回顾性分析 2013 年至 2015 年期间首次发生缺血性脑卒中的 356 例连续患者。在基线时测量血清 25(OH)D 水平。入院时采用美国国立卫生研究院卒中量表(NIHSS)评分评估卒中严重程度。发病后 3 个月采用改良 Rankin 量表(mRS)评估功能结局。

结果

在纳入的 356 例患者中,不足/缺乏组的 HbA1c 高于充足组(6.3±1.7 vs. 5.9±1.1,p=0.015)。不足/缺乏组的住院时间长于充足组(11(8-17)vs. 9.5(7-13),p=0.035)。使用逻辑回归分析,血清 25(OH)D 水平与住院时间之间存在显著的负相关趋势(OR 0.960,P=0.031)。

结论

25(OH)D 水平与血糖稳态有关,25(OH)D 有助于延长住院时间。低血清 25-OHD 水平是首次缺血性脑卒中住院时间的独立预测因子。维生素 D 缺乏症在 3 个月内不能预测功能结局。

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