Vitamin D status and its association with season, depression in stroke.
Neurosci Lett. 2018 Sep 24. pii: S0304-3940(18)30650-5. doi: 10.1016/j.neulet.2018.09.046. [Epub ahead of print]
Gu Y1, Zhu Z2, Luan X2, He J3.
- 1 Department of Psychiatry, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
- 2 Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
- 3 Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China. hjc at wmu.edu.cn.
- Overview Stroke and vitamin D
- Following a stroke, a hip fracture is 6X more likely if low vitamin D – July 2001
- Both are associated with low vitamin D
- Stroke outcome 6.9 X worse if black and overweight (all three related via low vitamin D) – March 2018
- Ischemic Stroke risk reduced by 2.5 if have good level of vitamin D – meta-analysis Feb 2018
- Migraines double the risk of strokes (both are associated with low vitamin D) – Jan 2018
Items in both categories Stroke and Depression are listed here:
- Post-stroke depression not reduced by 2,000 IU of vitamin D (not a surprise) – Nov 2021
- Depression is associated with stroke if low vitamin D or winter – Nov 2018
- Depression following a stroke is 2.7 X more likely if low vitamin D – Sept 2018
- Omega-3 and Vitamin D each treat many mental health problems - April 2018
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- No longer depressed, but risk of stroke is still 1.7X higher (did not consider low vitamin D) – May 2015
- ALL of the top 10 health problems of women are associated with low vitamin D
- Post stroke depression 9X more likely if low vitamin D – Dec 2014
- Stroke patients with low vitamin D were 10X more likely to become depressed – Aug 2014
Items in both categories Stroke and Injection are listed here:
- Improved recovery from ischemic stroke with Vitamin D (300,000 IU injection) – RCT June 2018
- Post stroke Calcitriol injections reduced edema and cell death (in rats) – Nov 2017
- 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
Vitamin D plays a key role in depression. In this study, we aimed to assess the prevalence of vitamin D deficiency or insufficiency and the association between vitamin D status and depression in patients with acute stroke.
From September 2013 to May 2015, consecutive patients with acute stroke were enrolled in this study within 7 days of symptom onset. Clinical information was collected during admission, and stroke severity was assessed at discharge. Depressive symptoms were measured by the 17-item Hamilton Rating Scale for Depression at 1 month after stroke. Based on the depressive symptoms, diagnoses of depression were made in accordance with DSM-IV criteria. Serum vitamin D levels were measured at admission. Binary logistic regression models were used to determine the association between depression and vitamin D levels treated as either absolute values (categorized as deficiency, insufficiency and sufficiency) or month-specific tertiles. Vitamin D levels were categorized by month-specific tertiles (high, intermediate, low) to reflect seasonal variation of serum vitamin D levels.
A total of 442 patients were enrolled in this study. The prevalence of vitamin D deficiency (< 30 nmol/L) or insufficiency (30-49.99 nmol/L) was 46%. The prevalence of vitamin D deficiency was significantly different in winter compared to summer months (p < 0.001). One hundred seven patients (26.6%) were diagnosed with depression at 1 month. In multivariable analyses, after fully adjusting for other potential confounders, the prevalence of depression was significantly higher in patients in the low tertile (odds ratio(OR) 2.24, 95% confidence interval (CI)1.18 to 4.26; p = 0.014) compared to the high tertile, and the prevalence of depression was also significantly higher in patients with vitamin D deficiency (OR 2.66, 95% CI 1.48 to 4.77; p = 0.001) and insufficiency (OR 1.93, 95% CI 1.00 to 3.74; p = 0.049) compared to those with vitamin D sufficiency.
Vitamin D deficiency and insufficiency occur at high rates in acute stroke patients. Low serum vitamin D levels were associated with depression in patients with acute stroke as analyzed by both the absolute level of vitamin D and month-specific tertiles. Intervention studies are needed to determine the benefits of vitamin D supplementation for depression in poststroke patients.