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Serum 25‐hydroxyvitamin D deficiency predicts poor outcome amongst acute ischaemic stroke patients with low high density lipoprotein cholesterol
Author(s) -
Xu T.,
Zhong C.,
Peng Y.,
Chen C.S.,
Wang J.,
Ju Z.,
Li Q.,
Geng D.,
Sun Y.,
Zhang D.,
Zhang Y.,
Chen J.,
Xu T.,
Zhang Y.,
He J.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13121
Subject(s) - medicine , ischaemic stroke , acute stroke , stroke (engine) , cardiology , cholesterol , ischemia , tissue plasminogen activator , mechanical engineering , engineering
Background and purpose Current observational studies indicate that a lower vitamin D level is associated with a higher risk of poor ischaemic stroke prognosis. Whether this association is affected by lipid levels is unclear. Our aim was to examine the effect of serum vitamin D especially its deficiency on the global outcome of ischaemic stroke stratified by individual lipid component level. Methods A total of 3181 ischaemic patients from China Antihypertensive Trial in Acute Ischaemic Stroke were included in this study and their baseline serum 25‐hydroxyvitamin D levels were tested. They were prospectively followed up for death, major disability and vascular events for 3 months after acute ischaemic stroke. A multivariable logistic model was used to evaluate the association between serum 25‐hydroxyvitamin D levels and clinical outcomes of ischaemic stroke in the 3‐month period of follow‐up in all patients and in different lipid‐level subgroups. Results Vitamin D deficiency was associated with poor clinical outcomes only in ischaemic stroke patients with high density lipoprotein cholesterol ( HDLC ) <1.04 mmol/l rather than all patients. The multivariable adjusted odds ratios (95% confidence intervals) of major disability and composite adverse events were 1.98 (1.08–3.63) and 2.24 (1.22–4.12), respectively. There was a significant interaction effect between vitamin D and HDLC levels on major disability and the composite outcome ( P for interaction < 0.05 for both). A significant linear trend existed between 25‐hydroxyvitamin D and risk of poor prognosis ( P = 0.03). Conclusions Vitamin D deficiency may be merely an independent risk factor of poor prognosis in ischaemic stroke patients with low HDLC level.