Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study

Hanpei Miao; Hanyu Zhu; Xiaoqian Luan; Guiqian Huang; Meixia Chen; Zhengzhong Yuan; Zhen Wang

doi:10.3389/fnagi.2020.613498

Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study

Front Aging Neurosci. 2021 Jan 18:12:613498. doi: 10.3389/fnagi.2020.613498. eCollection 2020.

Authors

Hanpei Miao¹, Hanyu Zhu², Xiaoqian Luan², Guiqian Huang², Meixia Chen³, Zhengzhong Yuan⁴, Zhen Wang²

Affiliations

¹ Department of Ophthalmology, Wenzhou Medical University, Wenzhou, China.
² Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³ Department of Neurology, The Yuhuan People's Hospital, Taizhou, China.
⁴ Department of Traditional Chinese Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Abstract

Purpose: Lower serum vitamin D has been reported to be associated with stroke. This study aimed to analyze the risk factors of vitamin deficiency in Chinese stroke patients, and further analyze its impact in different gender and their clinical variables.

Methods: 982 stroke patients were enrolled. Laboratory parameters such as serum vitamin D, apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB), ApoA-I/ApoB, cholesterol (CH), fibrinogen (FIB), blood glucose (Glu), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were collected and recorded. The severity of stroke was assessed by National Institute of Health Stroke Scale (NIHSS) score. Based on their serum vitamin D level, patients were divided into three groups: Vitamin D deficiency (<50 nmol/L), vitamin D insufficiency (≥50-75 nmol/L) and vitamin D sufficiency (≥75 nmol/L) and differences were compared among the three groups. Statistical analyses were done to assess the risk factors for serum vitamin D deficiency in our ischemic stroke patients.

Results: Gender, NIHSS, and FIB showed significant differences among the vitamin D groups (P < 0.001 ∼ P = 0.002). The female gender (OR = 2.422, P < 0.001), severity of stroke using NIHSS (OR = 1.055, P = 0.008) and FIB (OR = 1.256, P = 0.005) were risk factors of vitamin D deficiency in ischemic stroke patients. In subgroup analysis, NIHSS was significantly associated with vitamin D deficiency in the male group (OR = 1.087, P = 0.002) and higher FIB group (OR = 1.078, P = 0.001).

Conclusions: The female gender, severity of stroke using NIHSS and FIB were risk factors for vitamin D deficiency in our incident stroke patients. NIHSS was more sensitive to vitamin D deficiency in male ischemic stroke patients. Besides, under higher FIB circumstance, the increasing NIHSS score was more related to the vitamin D deficiency. Levels of vitamin D in patients with ischemic stroke should be well monitored during the disease cascade.

Keywords: Chinese; National Institute of Health Stroke Scale score; fibrinogen; ischemic stroke; vitamin D.