Low Serum Levels of 25-Hydroxyvitamin D Are Associated with Stroke Recurrence and Poor Functional Outcomes in Patients with Ischemic Stroke

Abstract

Objective: To evaluate the association between serum 25(OH) D levels and functional outcome and stroke recurrence events in a 6-month follow-up study in a cohort of patients with an acute ischemic stroke (AIS).

Methods: From March 2014 to August 2015, consecutive first-ever AIS patients admitted to the Department of Emergency of our hospital were identified. Serum 25(OH) D levels were measured at admission. Functional outcome was evaluated at 6-month using the modified Rankin scale (m-Rankin). We used logistic regression models to assess the relationship between 25(OH) levels and risk of recurrent stroke or functional outcome.

Results: We recorded 277 stroke patients. There were significantly negative correlation between levels of 25(OH) D and NHISS (P<0.001), and the infarct volume (P< 0.001). Thirty-one patients (11.9%) had a stroke recurrence, while 82 patients (29.6) were with poor functional outcomes. In multivariate logistic regression analyses, serum 25(OH) D level was an independent marker of poor functional outcome and stroke recurrence [odds ratio (OR) 2.55 (1.38-3.96) and 3.03(1.65-4.12), respectively, P<0.001 for both, adjusted for NHISS, other predictors and vascular risk factors] in patients with AIS.

Conclusion: Our results demonstrate that low 25(OH) D levels are associated with stroke recurrence and support the hypothesis that 25(OH) D may serve as a biomarker of poor functional outcome after stroke.

Keywords: 25-hydroxyvitamin D; functional outcome; ischemic stroke; stroke recurrence.