Ischemic Stroke and Vitamin D - many studies

Ischemic Stroke: This type of stroke occurs when a blood clot blocks or narrows an artery leading to the brain, reducing blood flow. It can be caused by thrombosis (a clot forming in the brain artery) or embolism (a clot traveling from another part of the body to the brain).
Hemorrhagic Stroke: This occurs when a blood vessel in the brain ruptures, leading to bleeding in or around the brain. It can be caused by high blood pressure, aneurysms, or arteriovenous malformations.

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Ischemic stroke score 2 X better if sufficient vitamin D – Sept 2024

Impact of Vitamin D Deficiency on Ischemic Stroke Severity: Insights from a Prospective Study
Cureus 16(9): e69376. DOI 10.7759/cureus.69376
Jibin Simon 1, Tirumalasetty Sriharsha 1, Ananthakumar Perumal Kumaresan 1, Utham Chand 1,
Sharan Bose 1
Internal Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND

Stroke 2X less severe if sufficient Vitamin D
Stroke perhaps 4X less severe if optimal vitamin D

Background
Ischemic stroke, characterized by the obstruction of blood flow to the brain, is a major cause of morbidity and mortality worldwide. The severity of ischemic stroke is commonly assessed using the National Institutes of Health Stroke Scale (NIHSS), which helps predict patient outcomes. Recent research suggests a potential link between low vitamin D levels and an increased risk of cerebrovascular events, including ischemic stroke. However, the specific relationship between vitamin D deficiency and stroke severity remains underexplored.

Objectives
The study aimed to investigate the correlation between serum vitamin D levels and NIHSS scores in patients with ischemic stroke to determine whether vitamin D deficiency is associated with the severity of neurological deficits in these patients.

Materials and methods
This prospective observational study was conducted at Saveetha Medical College, Chennai, and involved 86 patients presenting with acute ischemic stroke. Inclusion criteria were age >18 years, a confirmed diagnosis of acute ischemic stroke by neuroimaging, and presentation within 24 hours of symptom onset. Exclusion criteria included hemorrhagic stroke, conditions affecting vitamin D metabolism, and current vitamin D supplementation. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using chemiluminescence immunoassay (CLIA), and NIHSS scores were assessed within 24 hours of admission. Statistical analyses included Pearson’s correlation and multivariate linear regression to adjust for confounding variables.

Results
The study found that lower serum 25(OH)D levels were correlated with higher severity of stroke symptoms, as indicated by a significant negative correlation between 25(OH)D levels and NIHSS scores at admission (Pearson correlation coefficient r = -0.4081, p < 0.001). Multivariate regression analysis confirmed this association (p = -0.3994, p < 0.001) after adjusting for age, sex, and comorbidities, with p < 0.05 considered statistically significant. In addition, age (p = 0.1123, p = 0.009) and comorbid conditions (p = 0.9565, p = 0.008) were significantly associated with higher NIHSS scores.

Conclusion
The study demonstrates a significant negative correlation between serum 25-hydroxyvitamin D levels and ischemic stroke severity, suggesting that higher vitamin D levels may be associated with less severe strokes. Further research is needed to explore the mechanistic pathways and therapeutic potential of vitamin D in stroke management. Emphasizing the importance of maintaining adequate vitamin D levels could be crucial for potentially reducing stroke severity and improving patient outcomes.
 Download the PDF from VitaminDWiki

The NIHSS consists of 15 items

Level of consciousness
Orientation questions
Response to commands
Gaze deviation
Visual fields
Facial palsy
Motor arm (left and right)
Motor leg (left and right)
Limb ataxia
Sensory
Language
Dysarthria
Extinction and inattention

Each item is scored on a scale of 0 to 2, 3, or 4, with 0 being normal and higher scores indicating greater impairment.

The total NIHSS score ranges from 0 to 42, with higher scores indicating greater stroke severity.
Scores <5: 80% of stroke survivors are likely to be discharged to home
Scores 6-13: Patients typically require acute inpatient rehabilitation
Scores >14: Patients frequently require long-term skilled care

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Ischemic Stroke is 18% more likely if poor Vitamin D genes (unless take more Vitamin D) – Feb 2024

Causal effect of serum 25 hydroxyvitamin D concentration on cardioembolic stroke: Evidence from two-sample Mendelian randomization
Nutrition, Metabolism, and Cardiovascular Disease :https://doi.org/10.1016/j.numecd.2024.02.013

It seems that there are two groups of genes

Highlights

• Genetically predicted serum 25 hydroxyvitamin D concentration is associated with the risk of cardioembolic stroke.
• Mendelian Randomization analysis provides suggestive evidence that increased 25(OH)D levels may play a protective role in the development of cardioembolic stroke.
• Determining the role of 25(OH)D in stroke subtypes may be beneficial for the prevention of cardioembolic strokes.

Background and aims
The putative association between serum 25-hydroxyvitamin D concentration [25(OH)D] and the risk of cardioembolic stroke (CES) has been examined in observational studies, which indicate controversial findings. We performed Mendelian randomization (MR) analysis to determine the causal relationship of serum 25(OH)D with the risk of CES.

Methods and results
The summary statistics dataset on the genetic variants related to 25(OH)D was used from the published GWAS of European descent participants in the UK Biobank, including 417,580 subjects, yielding 143 independent loci in 112 1-Mb regions. GWAS summary data of CES was obtained from GIGASTROKE Consortium, which included European individuals (10,804 cases, 1,234,808 controls). Our results unveiled a causal relationship between 25(OH)D and CES using IVW [OR = 0.82, 95% CI: 0.67–0.98, p = 0.037]. Horizontal pleiotropy was not seen [MR-Egger intercept = 0.001; p = 0.792], suggesting an absence of horizontal pleiotropy. Cochrane's Q [Q = 78.71, p-value = 0.924], Rucker's Q [Q = 78.64, p-value = 0.913], and I2 = 0.0% (95% CI: 0.0%, 24.6%) statistic suggested no heterogeneity. This result remained consistent using different MR methods and sensitivity analyses, including Maximum likelihood [OR = 0.82, 95%CI: 0.67–0.98, p-value = 0.036], Constrained maximum likelihood [OR = 0.76, 95%CI: 0.64–0.90, p-value = 0.002], Debiased inverse-variance weighted [OR = 0.82, 95%CI: 0.68–0.99, p-value = 0.002], MR-PRESSO [OR = 0.82, 95%CI 0.77–0.87, p-value = 0.022], RAPS [OR = 0.82, 95%CI 0.67–0.98, p-value = 0.038], MR-Lasso [OR = 0.82, 95%CI 0.68–0.99, p-value = 0.037].

Conclusion
Our MR analysis provides suggestive evidence that increased 25(OH)D levels may play a protective role in the development of cardioembolic stroke. Determining the role of 25(OH)D in stroke subtypes has important clinical and public health implications.
 Download the preprint PDF from VitaminDWiki

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25+ VitaminDWiki Stroke pages have ISCHEMIC OR ISCHAEMIC in the title

This list is automatically updated

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VitaminDWiki – Stroke category contains

130 items in stroke category - see also Overview Stroke and vitamin D,
Overview Hypertension and Vitamin D  Overview Cardiovascular and vitamin D

Stroke more likely if low Vitamin D

• Stroke 74% less likely if high vitamin D (7,295 women 20-50 years old) – July 2017
• Stroke is 13.5 X more likely if low vitamin D and high blood pressure – March 2015
• Ischemic stroke 17 X more likely if low vitamin D – April 2017
• Stroke is strongly associated with Calcification of cerebral arteries (perhaps low Vitamin D, Vitamin K, Mg…) – March 2018
• Ischemic Stroke 3X more likely if Vitamin D Receptor gene change (Fok 1) – Jan 2014

Post-Stroke worse if low Vitamin D

• Poor Acute Ischemic Stroke 4X more likely if low Vitamin D - Nov 2023
• Stroke risks increased if low Vitamin D: Death 3.6 X, recurrence 5.5 X – Meta-analysis Nov 2019
• Stroke outcome at 3 months was 3X worse if bad stroke and low vitamin D – Jan 2020
• Death after Ischemic Stroke 2.5 X more likely if less than 10 ng of Vitamin D – May 2019
• Vascular dementia (after strokes) 32X more likely in Hypertensives with low vitamin D – Oct 2015
• Depression following a stroke is 2.7 X more likely if low vitamin D – Sept 2018
• Stroke incidence not associated with low Vitamin D (but stroke outcome is) – Aug 2019

Post-Stroke better if add Vitamin D

• Post-stroke Vitamin D supplementation helped in 11 ways – May 2023
• Improved recovery from ischemic stroke with Vitamin D (300,000 IU injection) – RCT June 2018
• Better outcome following Ischemic stroke if injected with 600,000 IU of vitamin D – RCT Feb 2017
• Ischaemic stroke – Vitamin D doubled survival (Injection followed by monthly 60,000 IU) – RCT Aug 2016
• Stroke patients need more than 2,000 IU of vitamin D (found this time in Japan) – RCT June 2019

Post-Stroke better if Vitamin D actually gets to cells

• Resveratrol fights Parkinson, Alzheimers, Diabetes, Cardiovascular, ALS, Stroke, etc.– Nov 2018
• Stroke rehabilitation (and prevention) requires Vitamin D actually getting to cells – March 2020

10 studies in both categories of Depression and Stroke

This list is automatically updated

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