Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 6 Issue 4

Study of the Relationship between Vitamin D Status in Acute Ischemic Stroke and Initial Severity and Short-Term Outcome in a Tertiary Level Hospital, Bangladesh

Aminur Rahman1*, Muhammad Jamil Ahmed2, Abul Hasnat Russel2, Mohammed Nazmul Huq3, Md Nurul Amin Miah4 and Zahed Ali5

1Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka, Bangladesh
2Resident, Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
3Professor, Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh
4Professor, Department of Medicine, Sheikh Hasina Medical College Tangail, Bangladesh
5Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka, Bangladesh

*Corresponding Author: Aminur Rahman, Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka, Bangladesh.

Received: October 22, 2022; Published: March 23, 2023

Abstract

Background: As per recent research, vitamin D, a neuroprotective prohormone, may serve as a defense against neurovascular injury. Low vitamin D levels had a modest risk of stroke and fatal stroke.

Objective: This research aimed to see the relationship between vitamin D status relates to initial severity and short-term outcome in patients with acute ischemic stroke.

Methods: The study included 51 patients with acute ischemic stroke and 51 matched healthy control participants. According to their levels of vitamin D, the subjects were split into three groups: deficient, insufficient, and sufficient. All patients underwent the modified Rankin Scale (mRS) at discharge and after three months, as well as the National Institutes of Health Stroke Scale (NIHSS) during admission and after 72 hours. Results: When compared to healthy participants (5.8%), acute ischemic stroke patients (9.8%) had considerably lower serum vitamin D levels. Serum vitamin D levels in patients ranged from 5 to 41 ng/ml, with a mean of 19.4 ng/ml. Serum vitamin D concentrations in controls ranged from 6 to 48 ng/ml, with a mean of 30.310.48 ng/ml. Stroke patients (66.7%) had considerably higher rates of vitamin D deficiency and insufficiency than healthy controls (51.9%). Serum vitamin D levels and NIHSS scores at admission and 72 hours later showed a significant connection (p = 0.007). Additionally, a significant connection between serum vitamin D levels and mRS scores at discharge and three months later was found (p = 0.004). Patients who reported having a major stroke were 11.2 times more likely to have 'insufficient' vitamin D (i.e., deficient and insufficient) (p = 0.006).

Conclusion: Vitamin D deficiency increases the risk of an acute ischemic stroke and is related to a worse short-term outcome as well as a more severe initial stroke.

Keywords: Vitamin D; Acute Ischemic Stroke; Stroke Severity; Stroke Outcome

References

  1. Kim AS and Johnston SC. “Temporal and geographic trends in the global stroke epidemic”. Stroke 44 (2013): S123-1255.
  2. Feigin VL., et al. “Global burden of stroke”. Circulation Research 120 (2017): 439-448.
  3. Al Mheid I and Quyyumi AA. “Vitamin D and cardiovascular disease: Controversy unresolved”. Journal of the American College of Cardiology 70 (2017): 89-100.
  4. Alkhatatbeh MJ., et al. “High prevalence of vitamin D deficiency and correlation of serum vitamin D with cardiovascular risk in patients with metabolic syndrome”. Metabolic Syndrome and Related Disorders 15 (2017): 213-219.
  5. Gupta A., et al. “Effect of vitamin D and calcium supplementation on ischaemic stroke outcome: a randomised controlled open-label trial”. International Journal of Clinical Practice 9 (2016): 764-770.
  6. Nair R and Maseeh A. “Vitamin D: the “sunshine” vitamin”. Journal of Pharmacology and Pharmacotherapeutics 2 (2012): 118-126.
  7. Uluduz D., et al.“Vitamin D deficiency and osteoporosis in stroke survivors: an analysis of National Health and Nutritional Examination Survey (NHANES)”. Journal of Vascular and Interventional Neurology 1 (2014): 23-28.
  8. Eyles DW., et al.“Distribution of the vitamin D receptor and 1 α-hydroxylase in human brain”. Journal of Chemical Neuroanatomy 1 (2005): 21-30.
  9. Makariou SE., et al.“Vitamin D and stroke: promise for prevention and better outcome”. Current Vascular Pharmacology 1 (2014): 117-124.
  10. Zhou R., et al.“Lower vitamin D status is associated with an increased risk of ischemic stroke: a systematic review and meta-analysis”. Nutrients 3 (2018): 277.
  11. Park KY., et al.“Serum Vitamin D Status as a Predictor of Prognosis in Patients with Acute Ischemic Stroke”. Cerebrovascular Diseases 1-2 (2015): 73-80.
  12. Sun Q., et al.“25-Hydroxyvitamin D levels and the risk of stroke: a prospective study and meta-analysis”. Stroke 6 (2012): 1470-1477.
  13. Turetsky A., et al.“Low serum vitamin D is independently associated with larger lesion volumes after ischemic stroke”. Journal of Stroke and Cerebrovascular Diseases 7 (2015): 1555-1563.
  14. Kasner SE. “Clinical interpretation and use of stroke scales”. Lancet Neurology7 (2006): 603-612.
  15. Sulter G., et al.“Use of the Barthel index and modified Rankin scale in acute stroke trials”. Stroke8 (1999): 1538-1541.
  16. Yarlagadda K., et al.“Vitamin D and Stroke: Effects on Incidence, Severity, and Outcome and the Potential Benefits of Supplementation”. Frontiers in Neurology 11 (2020): 384.
  17. National Institute of Neurological Disorders and Stroke (U.S.). NIH Stroke Scale. [Bethesda, Md.?]: National Institute of Neurological Disorders and Stroke, Dept. of Health and Human Services, USA (2011).
  18. Majumdar V., et al.“Vitamin D status, hypertension and ischemic stroke: a clinical perspective”. Journal of Human Hypertension 29 (2015): 669-674.
  19. Brøndum-Jacobsen P., et al.“25-hydroxyvitamin D and symptomatic ischemic stroke: an original study and meta-analysis”. Annals of Neurology 73 (2013): 38-47.
  20. Michos ED., et al.“25 (OH) D deficiency is associated with fatal stroke among whites but not blacks: the NHANES-III linked mortality files”. Nutrition 28 (2012): 367-371.
  21. Fahmy E., et al.“Vitamin D status in acute ischemic stroke: relation to initial severity and short-term outcome”. Egyptian Journal of Neurology, Psychiatry and Neurosurgery 55 (2019): 18.
  22. Wei ZN and Kuang JG. “Vitamin D deficiency in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke”. Bioscience Reports2 (2018): BSR20171509.
  23. Rezaei O., et al.“Does vitamin D administration play a role in outcome of patients with acute ischemic stroke? A randomized controlled trial”. Current Journal of Neurology 1 (2021): 8-14.

Citation

Citation: Aminur Rahman., et al. “Study of the Relationship between Vitamin D Status in Acute Ischemic Stroke and Initial Severity and Short-Term Outcome in a Tertiary Level Hospital, Bangladesh". Acta Scientific Neurology 6.4 (2023): 68-79.

Copyright

Copyright: © 2023 Aminur Rahman., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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