Vitamin D deficiency is associated with acute ischemic stroke, C-reactive protein, and short-term outcome

被引:63
作者
Alfieri, Daniela Frizon [1 ]
Lehmann, Marcio Francisco [2 ]
Oliveira, Sayonara Rangel [1 ]
Flauzino, Tamires [1 ]
Delongui, Francieli [1 ]
Martins de Araujo, Maria Caroline [3 ]
Dichi, Isaias [4 ]
Delfino, Vinicius Daher [4 ]
Mezzaroba, Leda [5 ]
Colado Simao, Andrea Name [5 ]
Vissoci Reiche, Edna Maria [5 ]
机构
[1] Univ Estadual Londrina, Hlth Sci Ctr, Postgrad Program, Londrina, Parana, Brazil
[2] Univ Estadual Londrina, Hlth Sci Ctr, Dept Clin Surg, Londrina, Parana, Brazil
[3] Univ Estadual Londrina, Hlth Sci Ctr, Sch Med, Londrina, Parana, Brazil
[4] Univ Estadual Londrina, Hlth Sci Ctr, Dept Clin Med, Londrina, Parana, Brazil
[5] Univ Estadual Londrina, Hlth Sci Ctr, Dept Pathol Clin Anal & Toxicol, Av Robert Koch 60, BR-86038440 Londrina, Parana, Brazil
关键词
Stroke; Vitamin D; Inflammation; C-reactive protein; VitaminD deficiency; SERUM 25-HYDROXYVITAMIN D; NUTRITION EXAMINATION SURVEY; HUMAN ENDOTHELIAL-CELLS; 3RD NATIONAL-HEALTH; CARDIOVASCULAR-DISEASE; 1,25-DIHYDROXYVITAMIN D-3; SMOOTH-MUSCLE; D PREDICTS; T-CELLS; EXPRESSION;
D O I
10.1007/s11011-016-9939-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to investigate whether vitamin D deficiency (VDD) is associated with acute ischemic stroke, inflammatory markers, and short-term outcome. 168 acute ischemic stroke patients and 118 controls were included. The modified Rankin Scale (mRS) was applied up to 8 h of admission (baseline) and after three-months follow-up, and blood samples were obtained up to 24 h of admission to evaluate serum levels of 25-hydroxivitamin D [25(OH) D] and inflammatory markers. Vitamin D levels classified the individuals in sufficient (VDS >= 30.0 ng/mL), insufficient (VDI 20.0-29.9 ng/mL), and deficient (VDD < 20.0 ng/mL) status. Patients had lower levels of 25(OH) D, higher frequency of VDD (43.45% vs. 5.08%, OR: 16.64, 95% CI: 5.66-42.92, p < 0.001), and higher inflammatory markers than controls (p < 0.05). Patients with VDD showed increased high sensitivity C-reactive protein (hsCRP) levels than those with VDS status (p = 0.043); those with poor outcome presented with lower 25(OH) D levels than those with good outcome (p = 0.008); moreover, 25(OH) D levels were negatively correlated with mRS after three-months follow-up (r = -0.239, p = 0.005). The associations between VDD and higher hsCRP levels and between 25(OH) D levels and poor outcome at short-term in acute ischemic stroke patients suggest the important role of vitamin D in the inflammatory response and pathophysiology of this ischemic event.
引用
收藏
页码:493 / 502
页数:10
相关论文
共 62 条
[21]   Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report [J].
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, R ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Cleeman, JI ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ ;
Keller, SA ;
Jehle, AJ .
CIRCULATION, 2002, 106 (25) :3143-3421
[22]  
Gupta Anu, 2014, Indian J Endocrinol Metab, V18, P721, DOI 10.4103/2230-8210.139241
[23]   Vascular smooth muscle cell activation by C-reactive protein [J].
Hattori, Y ;
Matsumura, M ;
Kasai, K .
CARDIOVASCULAR RESEARCH, 2003, 58 (01) :186-195
[24]   Vitamin D deficiency [J].
Holick, Michael F. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (03) :266-281
[25]   1,25-Dihydroxyvitamin D3 attenuates endotoxin-induced production of inflammatory mediators by inhibiting MAPK activation in primary cortical neuron-glia cultures [J].
Huang, Ya-Ni ;
Ho, Yi-Jung ;
Lai, Chien-Cheng ;
Chiu, Chien-Tsai ;
Wang, Jia-Yi .
JOURNAL OF NEUROINFLAMMATION, 2015, 12
[26]  
James PA, 2014, JAMA-J AM MED ASSOC, V311, P1809, DOI 10.1001/jama.2013.284427
[27]   Pharmacokinetics of vitamin D toxicity [J].
Jones, Glenville .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2008, 88 (02) :582S-586S
[28]   25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey [J].
Kendrick, Jessica ;
Targher, Giovanni ;
Smits, Gerard ;
Chonchol, Michel .
ATHEROSCLEROSIS, 2009, 205 (01) :255-260
[29]   Plasma 25-Hydroxyvitamin D and Its Genetic Determinants in Relation to Incident Myocardial Infarction and Stroke in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany Study [J].
Kuehn, Tilman ;
Kaaks, Rudolf ;
Teucher, Birgit ;
Hirche, Frank ;
Dierkes, Jutta ;
Weikert, Cornelia ;
Katzke, Verena ;
Boeing, Heiner ;
Stangl, Gabriele I. ;
Buijsse, Brian .
PLOS ONE, 2013, 8 (07)
[30]   Microglial cell population dynamics in the injured adult central nervous system [J].
Ladeby, R ;
Wirenfeldt, M ;
Garcia-Ovejero, D ;
Fenger, C ;
Dissing-Olesen, L ;
Dahnau, I ;
Finsen, B .
BRAIN RESEARCH REVIEWS, 2005, 48 (02) :196-206