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中国缺血性脑卒中患者维生素D缺乏的危险因素:一项横断面研究。

Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study.

作者信息

Miao Hanpei, Zhu Hanyu, Luan Xiaoqian, Huang Guiqian, Chen Meixia, Yuan Zhengzhong, Wang Zhen

机构信息

Department of Ophthalmology, Wenzhou Medical University, Wenzhou, China.

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

出版信息

Front Aging Neurosci. 2021 Jan 18;12:613498. doi: 10.3389/fnagi.2020.613498. eCollection 2020.

Abstract

PURPOSE

Lower serum vitamin D has been reported to be associated with stroke. This study aimed to analyze the risk factors of vitamin deficiency in Chinese stroke patients, and further analyze its impact in different gender and their clinical variables.

METHODS

982 stroke patients were enrolled. Laboratory parameters such as serum vitamin D, apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB), ApoA-I/ApoB, cholesterol (CH), fibrinogen (FIB), blood glucose (Glu), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were collected and recorded. The severity of stroke was assessed by National Institute of Health Stroke Scale (NIHSS) score. Based on their serum vitamin D level, patients were divided into three groups: Vitamin D deficiency (<50 nmol/L), vitamin D insufficiency (≥50-75 nmol/L) and vitamin D sufficiency (≥75 nmol/L) and differences were compared among the three groups. Statistical analyses were done to assess the risk factors for serum vitamin D deficiency in our ischemic stroke patients.

RESULTS

Gender, NIHSS, and FIB showed significant differences among the vitamin D groups ( < 0.001 ∼ = 0.002). The female gender (OR = 2.422, < 0.001), severity of stroke using NIHSS (OR = 1.055, = 0.008) and FIB (OR = 1.256, = 0.005) were risk factors of vitamin D deficiency in ischemic stroke patients. In subgroup analysis, NIHSS was significantly associated with vitamin D deficiency in the male group (OR = 1.087, = 0.002) and higher FIB group (OR = 1.078, = 0.001).

CONCLUSIONS

The female gender, severity of stroke using NIHSS and FIB were risk factors for vitamin D deficiency in our incident stroke patients. NIHSS was more sensitive to vitamin D deficiency in male ischemic stroke patients. Besides, under higher FIB circumstance, the increasing NIHSS score was more related to the vitamin D deficiency. Levels of vitamin D in patients with ischemic stroke should be well monitored during the disease cascade.

摘要

目的

据报道,血清维生素D水平较低与中风有关。本研究旨在分析中国中风患者维生素缺乏的危险因素,并进一步分析其在不同性别及其临床变量中的影响。

方法

纳入982例中风患者。收集并记录血清维生素D、载脂蛋白A-I(ApoA-I)、载脂蛋白B(ApoB)、ApoA-I/ApoB、胆固醇(CH)、纤维蛋白原(FIB)、血糖(Glu)、高密度脂蛋白(HDL)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)等实验室参数。采用美国国立卫生研究院卒中量表(NIHSS)评分评估中风的严重程度。根据血清维生素D水平,将患者分为三组:维生素D缺乏(<50 nmol/L)、维生素D不足(≥50-75 nmol/L)和维生素D充足(≥75 nmol/L),并比较三组之间的差异。进行统计分析以评估缺血性中风患者血清维生素D缺乏的危险因素。

结果

维生素D组之间的性别、NIHSS和FIB存在显著差异(<0.001~=0.002)。女性(OR=2.422,<0.001)、使用NIHSS评估的中风严重程度(OR=1.055,=0.008)和FIB(OR=1.256,=0.005)是缺血性中风患者维生素D缺乏的危险因素。在亚组分析中,NIHSS与男性组(OR=1.087,=0.002)和较高FIB组(OR=1.078,=0.001)的维生素D缺乏显著相关。

结论

女性、使用NIHSS评估的中风严重程度和FIB是我们所研究的中风患者维生素D缺乏的危险因素。NIHSS对男性缺血性中风患者的维生素D缺乏更敏感。此外,在FIB水平较高的情况下,NIHSS评分的增加与维生素D缺乏的关系更为密切。在疾病过程中,应密切监测缺血性中风患者的维生素D水平。

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