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维生素D补充剂对缺血性中风后接受康复治疗患者功能结局的影响:一项前瞻性、单盲、随机、安慰剂对照研究。

The Effect of Vitamin D Supplementation on Functional Outcomes in Patients Undergoing Rehabilitation After an Ischemic Stroke: A Prospective, Single-Blind, Randomized, Placebo-Controlled Study.

作者信息

Borowicz Wojciech, Ptaszkowska Lucyna, Małecki Rafał, Paprocka-Borowicz Małgorzata

机构信息

Department of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland.

Institute of Health Sciences, University of Opole, 45-060 Opole, Poland.

出版信息

J Clin Med. 2025 Mar 9;14(6):1848. doi: 10.3390/jcm14061848.

Abstract

: A vitamin D deficiency is prevalent in post-stroke patients and may impair neurological recovery. While observational studies highlight the neuroprotective role of vitamin D, there is limited evidence from interventional studies evaluating its impact on functional recovery during stroke rehabilitation. This study aimed to assess whether daily vitamin D3 supplementation enhances functional recovery. : This prospective, randomized, placebo-controlled, single-blind study included 159 patients (mean age: 62.5 ± 8.4 years) with a first ischemic stroke that were admitted for early rehabilitation. The participants were randomly allocated to receive 2000 IU of vitamin D3 daily ( = 79) or a placebo ( = 80) for six weeks. The functional outcomes were measured using the Barthel index (BI) and modified Rankin scale (mRS) at baseline and after 42 days. The serum 25-hydroxyvitamin D [25(OH)D] and insulin-like growth factor 1 (IGF-1) levels were analyzed. : Vitamin D3 supplementation significantly increased the serum 25(OH)D levels ( < 0.001). Supplementation was associated with improved BI scores (β = 0.07, = 0.006). A higher BMI (β = -0.06, = 0.033), higher NIHSS scores (β = -0.18, = 0.036), hypertension, and statin use negatively impacted functional recovery. Anticoagulant use was correlated with higher mRS scores, indicating greater disability ( = 0.04). : Vitamin D3 supplementation positively influences the functional outcomes during post-stroke rehabilitation, supporting its potential role in enhancing neuroplasticity and recovery. Larger multi-center trials are needed to confirm these findings and optimize vitamin D supplementation strategies.

摘要

维生素D缺乏在中风后患者中很普遍,可能会损害神经功能恢复。虽然观察性研究强调了维生素D的神经保护作用,但评估其对中风康复期间功能恢复影响的干预性研究证据有限。本研究旨在评估每日补充维生素D3是否能促进功能恢复。

这项前瞻性、随机、安慰剂对照、单盲研究纳入了159例首次发生缺血性中风并接受早期康复治疗的患者(平均年龄:62.5±8.4岁)。参与者被随机分配,每天接受2000 IU维生素D3(n = 79)或安慰剂(n = 80),为期六周。在基线和42天后,使用巴氏指数(BI)和改良Rankin量表(mRS)测量功能结局。分析血清25-羟维生素D[25(OH)D]和胰岛素样生长因子1(IGF-1)水平。

补充维生素D3显著提高了血清25(OH)D水平(P<0.001)。补充维生素D3与BI评分改善相关(β = 0.07,P = 0.006)。较高的体重指数(β = -0.06,P = 0.033)、较高的美国国立卫生研究院卒中量表(NIHSS)评分(β = -0.18,P = 0.036)、高血压和使用他汀类药物对功能恢复有负面影响。使用抗凝剂与较高的mRS评分相关,表明残疾程度更高(P = 0.04)。

补充维生素D3对中风后康复期间的功能结局有积极影响,支持其在增强神经可塑性和恢复方面的潜在作用。需要更大规模的多中心试验来证实这些发现并优化维生素D补充策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b19/11943436/068baf015bbe/jcm-14-01848-g001.jpg

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