Circulating vitamin D, calcium and risk of cerebrovascular disease: a systematic review and meta-analysis.
Eur J Epidemiol. 2012 Sep 9.
Chowdhury R, Stevens S, Ward H, Chowdhury S, Sajjad A, Franco OH.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.
Available literature suggests that both vitamin D and calcium may be associated with a wide range of non-skeletal outcomes. However, epidemiological evidence supporting their individual associations with incident cerebrovascular disease is scarce. We conducted a systematic review and meta-analysis of prospective cohort studies, published before February 2012 and sought from MEDLINE, EMBASE, BIOSIS and the Science Citation Index databases, and reported cerebrovascular disease (defined as any fatal or non-fatal ischemic stroke, hemorrhagic stroke, cerebrovascular accident or transient ischemic attack) by circulating vitamin D (25-hydroxy vitamin D [25(OH)D] as active metabolite) and calcium levels. Two independent investigators abstracted information on 25(OH)D and calcium, cerebrovascular outcomes and other characteristics from selected studies. Relative risks (RRs) were pooled by both random and fixed effects meta-analyses and were further examined under different study-level characteristics. Publication bias was assessed with funnel plots and Egger's asymmetry test. From 5,778 initial references, nine unique prospective cohort studies met our inclusion criteria.
Seven studies (involving 47,809 participants and 926 cerebrovascular events) focused on circulating 25(OH)D and 3 reported on circulating calcium (22,577 participants and 727 events).
For 25(OH)D, in a comparison of individuals in the top third versus those in the bottom third at baseline, the combined RR for cerebrovascular disease, adjusted for several conventional risk factors, was 0.60 (95 % CI 0.48, 0.72). The corresponding RR in the prospective studies that reported on baseline circulating calcium levels for cerebrovascular disease was 1.40 (95 % CI 1.19, 1.64). There was no apparent evidence of heterogeneity or publication bias among included studies. Available data indicate that higher circulating level of vitamin D is associated with a decreased risk of cerebrovascular disease. Conversely, higher circulating calcium concentration is associated with an increased risk of cerebrovascular disease.
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_ Items in both categories Stroke and Meta-analysis are listed here:
- Stroke risks increased if low Vitamin D: Death 3.6 X, recurrence 5.5 X – Meta-analysis Nov 2019
- Ischemic Stroke risk reduced by 2.5 if have good level of vitamin D – meta-analysis Feb 2018
- Vitamin D associated with 50 percent less ischemic stroke – meta-analysis Aug 2012
- Cerebrovascular disease 40 percent less likely if high level of vitamin D – meta-analysis Sept 2012
- 50 percent fewer strokes with vitamin D, even though ignored dose size – meta-analysis March 2012