Stroke risks increased if low Vitamin D: Death 3.6 X, recurrence 5.5 X – Meta-analysis

Prognostic utility of serum 25-hydroxyvitamin D in patients with stroke: a meta-analysis.

J Neurol. 2019 Nov 8. doi: 10.1007/s00415-019-09599-0.

* Stroke incidence not associated with low Vitamin D (but stroke outcome is) – Aug 2019 * Death after Ischemic Stroke 2.5 X more likely if less than 10 ng of Vitamin D – May 2019 * Ischemic stroke and low vitamin D – 3X higher risk of poor outcome, 6 X higher risk of a second stroke, Oct 2017 * Stroke outcome 6.9 X worse if black and overweight (all three related via low vitamin D) – March 2018 * Depression following a stroke is 2.7 X more likely if low vitamin D – Sept 2018 * Overview Stroke and vitamin D * Stroke mortality 3X worse among seniors with less than 26 ng of vitamin D – June 2014 * __Stroke category listing has items

Liu H1, Wang J1, Xu Z2.

1 Department of Neurology, China-Japan Union Hospital, Jilin University, No. 126, Xiantai Street, Erdao District, Changchun, 130000, Jilin, China.

2 Department of Neurology, China-Japan Union Hospital, Jilin University, No. 126, Xiantai Street, Erdao District, Changchun, 130000, Jilin, China. xzxxuzhongxin@sina.com.

BACKGROUND:

Conflicting findings have been reported on the prognostic significance of serum 25-hydroxyvitamin D level in patients with stroke. The objective of this meta-analysis was to evaluate the prognostic utility of serum 25-hydroxyvitamin D in stroke patients.

METHODS:

PubMed and Embase databases were systematically searched for potentially eligible studies until October 16, 2019. Observational studies investigating the association between serum 25-hydroxyvitamin D level and prognosis of patients with stroke were eligible. Multivariable adjusted risk ratios (RR) with 95% confidence intervals (CI) of poor functional outcome, all-cause mortality, and recurrence of stroke were pooled with the lowest versus the highest category of 25-hydroxyvitamin D level.

RESULTS:

Eleven articles (ten studies) involving 6845 stroke patients satisfied our predefined inclusion criteria. Lower serum 25-hydroxyvitamin D level was associated with an

• increased risk of poor functional outcome (RR 1.86; 95% CI 1.16-2.98),

• all-cause mortality (RR 3.56; 95% CI 1.54-8.25), and

• recurrence of stroke (RR 5.49; 95% CI 2.69-11.23).

Sensitivity analysis further confirmed the above findings.

CONCLUSIONS:

Lower serum 25-hydroxyvitamin D level is significantly associated with poorer prognosis in stroke patients. Future prospective studies are warranted to verify the prognostic role and to examine the association in different subtypes of stroke.