Decreasing serum 25-hydroxyvitamin D levels and risk of early neurological deterioration in patients with ischemic stroke.

BACKGROUND AND AIMS: Vitamin D deficiency has been linked to a higher risk of ischemic stroke. We therefore explored the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and early neurological deterioration (END) after acute ischemic stroke in a hospital-based prospective study.

METHODS: From June 2016 to June 2018, patients with ischemic stroke within 48 hr from symptom onset were consecutively recruited. Serum 25(OH)D levels were measured at admission. END was defined as an increase of ≥1 point in motor power or ≥2 points in the total National Institute of Health Stroke Scale score within 7 days after admission. Multiple logistic regression models were performed to calculate the odds ratio (OR) and confidence intervals (CI) of 25(OH)D levels in predicting END.

RESULTS: A total of 478 subjects were enrolled, of which 136 (28.5%) patients developed END. The mean 25(OH)D levels were 49.5 ± 15.8 nmol/L. Univariate logistic regression analysis showed that advanced age, white matter lesions, high level of body mass index, diastolic blood pressure, fasting blood glucose and homocysteine, and low 25(OH)D levels were associated with END. Furthermore, multivariate regression analysis demonstrated that the first quartile of 25(OH)D concentrations [OR, 2.628; 95% CI,1.223-5.644; p = 0.013] was independently risk factor for END.

CONCLUSIONS: This study illustrated that lower 25(OH)D levels might be associated with an increasing risk of END in acute ischemic stroke patients.