25-Hydroxyvitamin D levels and the risk of stroke: a prospective study and meta-analysis.
25-Hydroxyvitamin D levels and the risk of stroke: a prospective study and meta-analysis.
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DOI：
10.1161/strokeaha.111.636910
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发表时间：
2012-06
期刊：
影响因子：
8.3
通讯作者：
Rexrode KM
中科院分区：
文献类型：
--
作者：
Sun Q;Pan A;Hu FB;Manson JE;Rexrode KM
尽管有证据表明维生素D缺乏可能导致心血管疾病风险增加，但关于25(OH)D水平与中风风险之间的关系的结果尚不确定。我们的目标是在一项针对女性的前瞻性研究中检验这种相关性，并在荟萃分析中总结所有现有数据。在护士健康研究(NHS)中，我们测量了464名发生缺血性中风的女性和2006年未发生中风的同等数量的对照组的25(OH)D水平。我们在MEDLINE和EMBASE上搜索到2011年3月发表的文章，这些文章前瞻性地评估了25(OH)D水平与中风的关系。在对生活方式和饮食协变量进行多变量调整后，在NHS中，较低的25(OH)D水平与缺血性中风的风险增加相关：最低三分位数的女性与最高三分位数的女性相比的优势比(95%CI)为1.49(1.01，2.18；P趋势=0.04)。我们发现了另外6项前瞻性研究，考察了25(OH)D与中风预后的关系。在将我们的结果与这些前瞻性研究(总共包括1214例中风病例)合并后，与高水平相比，低25(OH)D水平与发生中风结局的风险增加相关：合并的相对风险(95%CI)为1.52(1.20，1.85；I2=0.0%，P异质性=0.63)。在两项明确检查缺血性中风的研究中，这一关联度为1.59(1.07，2.12；I2=0.0%，P异质性=0.80)。这些数据提供了证据，表明低维生素D水平与中风风险略有关联。保持足够的维生素D水平可能会降低女性中风的风险。
Despite evidence suggesting that vitamin D deficiency may lead to elevated cardiovascular disease risk, results regarding the association of 25(OH)D levels with stroke risk are inconclusive. We aimed to examine this association in a prospective study in women and to summarize all existing data in a meta-analysis. We measured 25(OH)D levels among 464 women who developed ischemic stroke and an equal number of controls who were free of stroke through 2006 in the Nurses’ Health Study (NHS). We searched MEDLINE and EMBASE for articles published through March 2011 that prospectively evaluated 25(OH)D levels in relation to stroke. After multivariable adjustment for lifestyle and dietary covariates, lower 25(OH)D levels were associated with an elevated risk of ischemic stroke in the NHS: the odds ratio (95% CI) comparing women in the lowest vs. highest tertiles was 1.49 (1.01, 2.18; Ptrend=0.04). We found 6 other prospective studies that examined 25(OH)D in relation to stroke outcomes. After pooling our results with these prospective studies that included 1,214 stroke cases in total, low 25(OH)D levels were associated with increased risk of developing stroke outcomes in comparison to high levels: the pooled relative risk (95% CI) was 1.52 (1.20, 1.85; I2 = 0.0%, Pheterogeneity=0.63). In two studies that explicitly examined ischemic stroke, this association was 1.59 (1.07, 2.12; I2 = 0.0%, Pheterogeneity=0.80). These data provide evidence that low vitamin D levels are modestly associated with risk of stroke. Maintaining adequate vitamin D status may lower risk of stroke in women.