Association of Serum 25(OH)D Levels with Infarct Volumes and Stroke Severity in Acute Ischemic Stroke
Association of Serum 25(OH)D Levels with Infarct Volumes and Stroke Severity in Acute Ischemic Stroke
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DOI：
10.1007/s12603-017-0926-z
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发表时间：
2018-01-01
影响因子：
5.8
通讯作者：
Zhang, J. -M.
中科院分区：
文献类型：
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作者：
Li, Y. -Y.;Wang, Y. -S.;Zhang, J. -M.
本研究的目的是利用弥散加权成像(DWI)研究急性缺血性卒中患者中25-羟基维生素D[25(OH)D]是否与初始卒中严重程度和脑梗塞体积相关。使用美国国立卫生研究院卒中评分(NIHSS)评估初始卒中严重程度。用弥散加权成像测量脑梗塞体积。采用多元线性和Logistic回归分析验证25(OH)D是否代表脑梗塞体积和卒中严重程度的独立预测因子(NIHSS评分为6)。在235名研究患者中，中位年龄为(智商56-75岁)，其中125名(53.2%)为女性。在调整了其他显著危险因素的多变量模型中，最低和第二个四分位数的25(OH)D水平与NIHSS6(以最高的25(OH)D四分位数为参考)的风险增加相关，其奇比(OR)分别为3.02(95%可信区间：1.59-6.34)和5.85(2.90-11.54)。血清25(OH)D水平从低到高四分位数的弥散加权成像脑梗塞体积的中位数分别为12.35、6.55、2.44和1.59ml，其中最低的四分位数的脑梗塞体积大于其他三个四分位数(P<；0.001)。血清25(OH)D水平最低四分位数的中位数调整后的DWI脑梗塞体积显著大于其他三个四分位数(P<；0.01)。总而言之，急性缺血性卒中患者血清25(OH)D水平降低是缺血组织体积增大和神经功能缺失加重的早期预测指标(由NIHSS评估)。
The aim of this study is to investigate whether 25-hydroxyvitamin D [25(OH) D] is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke.We studied a total of 235 patients who were admitted within 24 hours of acute ischemic stroke onset. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI. Multivariable linear and logistic regression analyses were used to test whether 25(OH) D represents an independent predictor of infarct volume and stroke severity (NIHSS score of 6).Among 235 study patients, the median age was 64 years (IQR 56-75 years), and 125 (53.2%) were women. In multivariable models adjusted for other significant risk factors, 25(OH) D levels in the lowest and second interquartiles were associated with an increased risk of a NIHSS6 (with highest 25 (OH) D quartile as reference) with odd ratios (OR) 3.02(95% confidence interval [CI]:1.59-6.34) and 5.85(2.90-11.54). The median DWI infarct volumes for the serum 25(OH) D level quartiles (lowest to highest) were 12.35, 6.55, 2.44, and 1.59 ml. The median DWI infarct volume in the lowest serum 25(OH) D level quartile was larger than that in the other 3 quartiles (P < 0.001). The median adjusted DWI infarct volume in the lowest serum 25(OH) D level quartile was statistically significantly larger than that in the other 3 quartiles (P < 0.01).In conclusion, reduced serum 25(OH) D levels in acute ischemic stroke are an early predictor of larger volumes of ischemic tissue and worse neurological deficit (assessed by the NIHSS).