Stroke risks increased if low Vitamin D: Death 3.6 X, recurrence 5.5 X – Meta-analysis Nov 2019

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.


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.

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