Simon Jibin, Sriharsha Tirumalasetty, Perumal Kumaresan Ananthakumar, Chand Utham, Bose Sharan
Internal Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Sep 13;16(9):e69376. doi: 10.7759/cureus.69376. eCollection 2024 Sep.
Background Ischemic stroke, characterized by the obstruction of blood flow to the brain, is a major cause of morbidity and mortality worldwide. The severity of ischemic stroke is commonly assessed using the National Institutes of Health Stroke Scale (NIHSS), which helps predict patient outcomes. Recent research suggests a potential link between low vitamin D levels and an increased risk of cerebrovascular events, including ischemic stroke. However, the specific relationship between vitamin D deficiency and stroke severity remains underexplored. Objectives The study aimed to investigate the correlation between serum vitamin D levels and NIHSS scores in patients with ischemic stroke to determine whether vitamin D deficiency is associated with the severity of neurological deficits in these patients. Materials and methods This prospective observational study was conducted at Saveetha Medical College, Chennai, and involved 86 patients presenting with acute ischemic stroke. Inclusion criteria were age ≥18 years, a confirmed diagnosis of acute ischemic stroke by neuroimaging, and presentation within 24 hours of symptom onset. Exclusion criteria included hemorrhagic stroke, conditions affecting vitamin D metabolism, and current vitamin D supplementation. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using chemiluminescence immunoassay (CLIA), and NIHSS scores were assessed within 24 hours of admission. Statistical analyses included Pearson's correlation and multivariate linear regression to adjust for confounding variables. Results The study found that lower serum 25(OH)D levels were correlated with higher severity of stroke symptoms, as indicated by a significant negative correlation between 25(OH)D levels and NIHSS scores at admission (Pearson correlation coefficient r = -0.4081, p < 0.001). Multivariate regression analysis confirmed this association (β = -0.3994, p < 0.001) after adjusting for age, sex, and comorbidities, with p < 0.05 considered statistically significant. In addition, age (β = 0.1123, p = 0.009) and comorbid conditions (β = 0.9565, p = 0.008) were significantly associated with higher NIHSS scores. Conclusion The study demonstrates a significant negative correlation between serum 25-hydroxyvitamin D levels and ischemic stroke severity, suggesting that higher vitamin D levels may be associated with less severe strokes. Further research is needed to explore the mechanistic pathways and therapeutic potential of vitamin D in stroke management. Emphasizing the importance of maintaining adequate vitamin D levels could be crucial for potentially reducing stroke severity and improving patient outcomes.
缺血性中风以脑部血流受阻为特征,是全球发病和死亡的主要原因。缺血性中风的严重程度通常使用美国国立卫生研究院卒中量表(NIHSS)进行评估,该量表有助于预测患者的预后。最近的研究表明,低维生素D水平与包括缺血性中风在内的脑血管事件风险增加之间可能存在联系。然而,维生素D缺乏与中风严重程度之间的具体关系仍未得到充分探索。
本研究旨在调查缺血性中风患者血清维生素D水平与NIHSS评分之间的相关性,以确定维生素D缺乏是否与这些患者的神经功能缺损严重程度相关。
这项前瞻性观察性研究在金奈的萨维塔医学院进行,纳入了86例急性缺血性中风患者。纳入标准为年龄≥18岁,经神经影像学确诊为急性缺血性中风,且在症状发作后24小时内就诊。排除标准包括出血性中风、影响维生素D代谢的疾病以及正在补充维生素D。使用化学发光免疫分析法(CLIA)测量血清25-羟基维生素D(25(OH)D)水平,并在入院后24小时内评估NIHSS评分。统计分析包括Pearson相关性分析和多变量线性回归分析,以调整混杂变量。
研究发现,较低的血清25(OH)D水平与较高的中风症状严重程度相关,入院时25(OH)D水平与NIHSS评分之间存在显著负相关(Pearson相关系数r = -0.4081,p < 0.001)。在调整年龄、性别和合并症后,多变量回归分析证实了这种关联(β = -0.3994,p < 0.001),p < 0.05被认为具有统计学意义。此外,年龄(β = 0.1123,p = 0.009)和合并症(β = 0.9565,p = 0.008)与较高的NIHSS评分显著相关。
该研究表明血清25-羟基维生素D水平与缺血性中风严重程度之间存在显著负相关,提示较高的维生素D水平可能与较轻的中风相关。需要进一步研究以探索维生素D在中风管理中的作用机制和治疗潜力。强调维持足够维生素D水平的重要性对于潜在降低中风严重程度和改善患者预后可能至关重要。