Vitamin D as a Predictor of Severity and Prognosis of Acute Ischemic Stroke

Abstract

Objective: The effect of vitamin D, which is a steroid hormone, on bone health has long been known. Vitamin D is also found to be associated with various diseases such as diabetes, hypertension, chronic kidney disease, coronary artery disease, and cancer. Neuroprotective effect of vitamin D makes it an important marker in clinical course of neurological diseases such as cognitive impairment, dementia and Alzheimer’s disease. Vitamin D deficiency is also associated with increased risk of stroke. In this study, we aimed to show the effect of vitamin D levels on severity and prognosis of stroke.

Materials and Methods: This was a prospective, observational study conducted in a tertiary medical center in Rohtak on 200 stroke patients admitted in Medicine ward. The National Institute of Health Stroke scale (NIHSS) and modified Rankin Scale were used to assess the severity of stroke at admission and functional outcome at 3 months, respectively. The patients were divided into 4 groups on the basis of vitamin D levels.

Results: Vitamin D deficiency was associated with higher NIHSS score and independently associated with poor functional outcome. Patients with severe and mild vitamin D deficiency, and vitamin D insufficiency had 9, 6.7, and 3.9 times higher adjusted odds of poorer functional outcomes at 3 months in comparison to the patients with normal vitamin D levels (p<0.01) when adjusted for age, sex, alcohol, smoking, body mass index, NIHSS score, and co-morbidities.

Conclusion: Vitamin D is associated with severe stroke and poor functional outcome at 3 months. However, further studies need to be carried out to evaluate whether supplementation of vitamin D can help prevent stroke or associated morbidity and mortality.

This study was duly approved by the Pt B D Sharma University of Health Sciences Ethics Committee (decision no:UHS/Aca-II/Eth/20/158) and the postgraduate board of studies of the institution.

Informed consent was taken from all participants.

Externally and internally peer-reviewed.

Surgical and Medical Practices: H.K.A., D.J., T.P., J.S., S.D., Concept: H.K.A., D.J., Design: H.K.A., D.J., T.P., Data Collection or Processing: T.P., J.S., S.D., Analysis or Interpretation: H.K.A., D.J., T.P., Literature Search: T.P., J.S., S.D., Writing: D.J., T.P., S.D.

No conflict of interest was declared by the authors.

The authors declared that this study received no financial support.