Low vitamin D at time of stroke predicts 3 X more likely to die in a month (unless add Vit D) – Dec 2017

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Serum levels of 25-hydroxyvitamin D predicts infarct volume and mortality in ischemic stroke patients Dec 2017

J Neuroimmunol. 2017 Dec 15;313:41-45. doi: 10.1016/j.jneuroim.2017.10.002. Epub 2017 Oct 5.

Low Vitamin D (Q1) predicts far more likely to die

Nie Z1, Ji XC2, Wang J3, Zhang HX4.

• 1 Department of Radiology,The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China. Electronic address: nieyisheng at 163.com.
• 2 EEG Room,The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
• 3 Department of Radiology,The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
• 4 Department of Spinal Surgery,Henan, Luoyang Bone-Setting Hospital, Luoyang, China.

BACKGROUND:
The aim of this study is to determine 25-hydroxyvitamin D [25(OH) D] levels in serum, and investigate their associations with cardiovascular disease (CVD) or all-cause mortality in a 1-year follow-up study in patients with first-ever ischemic stroke.

METHODS:
From November 2013 to October 2015, 387 consecutive patients with ischemic stroke admitted to our hospital were identified. Serum 25(OH) D levels were measured at admission. Infarct volume was measured using diffusion-weighted imaging (DWI). The primary end point was CVD mortality among 1year. The secondary end point was all-cause mortality.

RESULTS:
In this study, 387 patients were included. A statistically significant negative correlation between serum 25(OH) D level and infarct volume was found (r=-0.442; P<0.001). There were 74 patients (19.1%, 95%CI: 15.2%-23.0%) died, including 36 CVD mortality (9.3%, 95CI%: 6.4%-12.2%). The mortality distribution across the 25(OH) D quartiles ranged between 39.2% (first quartile) to 5.2% (fourth quartile) for all-cause mortality and between 18.6% (first quartile) to 2.1% (fourth quartile) for CVD mortality. In a multivariate model using the first quartiles of 25(OH) D vs. quartiles 2 through 4 together with the clinical variables, the marker displayed prognostic information CVD mortality: OR for first quartile, 3.06 [95% CI, 2.16-4.95]; all-cause mortality: OR for first quartile, 2.76 [95% CI, 2.01-4.32].

CONCLUSIONS:
The data show serum levels of 25(OH) D at admission is useful prognostic marker of CVD and all-cause mortality in Chinese patients with ischemic stroke.

PMID: 29153607 DOI: 10.1016/j.jneuroim.2017.10.002

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3.9 X more likely to die of stroke if low Vitamin D - Feb 2018

Vitamin D deficiency in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke.
Biosci Rep. 2018 Feb 5. pii: BSR20171509. doi: 10.1042/BSR20171509.
Wei ZN1, Kuang JG2.

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Objective To assess the hypothesis that vitamin D, reflected by 25-hydroxyvitamin D [25(OH)D] would be associated with higher risk of poor functional outcomes among nondiabetic stroke patients.

Methods This study was conducted in Nanchang, China. Serum concentration of 25(OH) D and NIH stroke scale (NIHSS) were measured at the time of admission. Functional outcome was measured by modified Rankin scale (mRS) at 1 year after admission. Multivariate analyses were performed using logistic regression models. The cut point of 25(OH) D level for vitamin D deficiency was 20ng/ml.

Results In this study, 266 nondiabetic subjects with stroke were included. One hundred and forty-nine out of the 266 patients were defined as vitamin D deficiency (56%). The poor outcome distribution across the 25(OH) D quartiles ranged between 64% (first quartile) to 13% (fourth quartile). In those 149 patients with vitamin D deficiency, 75 patients were defined as poor functional outcomes, giving a prevalence rate of 50% (95% confidence intervalCI: 42%-58%). In multivariate analysis models, for vitamin D deficiency, the adjusted risk of poor functional outcomes and mortality increased by 220% (odds ratios [OR]: 3.2; 95% CI, 1.7-4.2, P<0.001) and 290% (OR: 3.9; 95% CI, 2.1-5.8, P<0.001), respectively.

Conclusions Vitamin D deficiency is associated with an increased risk of poor functional outcome events in Chinese nondiabetic stroke individuals.

PMID: 29437901 DOI: 10.1042/BSR20171509