Role of Vitamin D in the Outcome  of Ischemic Stroke- A Randomized  Controlled Trial

Narasimhan, Shuba; Balasubramanian, P.

doi:10.7860/jcdr/2017/24299.9346

Cited by 40 publications

(41 citation statements)

References 35 publications

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“…However, the above studies had a limited representation of individuals from China. In our study, we further confirmed patients with SVD were correlated with the deficiency of 25(OH)D. Our study was in line with the former studies from different races including in Nepal, India, Iran and Italy [15,[31][32][33][34][35][36][37].…”

Section: Discussionsupporting

confidence: 90%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

BMC Neurol

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Background The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China. Methods We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12–20 ng/ml) and sufficiency (> 20 ng/ml). Results Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls ( P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level ( P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD ( OR 0.772, 95% CI 0.691–0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006–15.683) and 1.077 (95% CI : 0.338–3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398–39.540) and 1.108 (95% CI 0.232–5.280), respectively ( P interaction = 0.001). Conclusion We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

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Section: Discussionsupporting

confidence: 90%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

BMC Neurol

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“…Moreover, whereas it is now established that vitamin D modulates endothelial homeostasis and barrier function [128], a potential benefit of vitamin D in preventing or limiting the onset and severity of CCM disease has clearly emerged from both epidemiological studies and animal models [43,95,117,151,152]. On the other hand, the therapeutic effect of vitamin D supplementation remains controversial, as there is still some inconsistency in the conclusions of distinct RCTs and meta-analyses concerning its beneficial effects on oxidative stress biomarkers and CVD outcomes, including stroke, or on mortality [25,119,159,161,168,169,[195][196][197][198][199]. Such controversy is akin to that regarding the putative beneficial effects of antioxidants in optimizing health [200], with the reported discrepancies likely due to the complexity of the systems and existence of multiple confounding factors.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the therapeutic effect of vitamin D supplementation remains controversial, as there is still some inconsistency in the conclusions of distinct RCTs and meta-analyses concerning its beneficial effects on oxidative stress biomarkers and CVD outcomes, including stroke, or on mortality [25,119,159,161,168,169,[195][196][197][198][199]. Such controversy is akin to that regarding the putative beneficial effects of antioxidants in optimizing health [200], with the reported discrepancies likely due to the complexity of the systems and existence of multiple confounding factors.…”

Section: Discussionmentioning

confidence: 99%

“…These findings raise the possibility that low vitamin D serum levels, a treatable risk factor, might be targeted for the reduction of disability among stroke sufferers. Indeed, a study to assess the long-term effect of supplementation of vitamin D in ischemic stroke patients with low vitamin D levels found a significant improvement in the outcome after three months [168]. Nevertheless, the value of vitamin D supplementation in preventing stroke is still unclear, as a recent meta-analysis of randomized clinical trials conducted in more than 80,000 patients found no clinical benefit of vitamin D supplementation in reducing the incidence of (as opposed to outcome from) major cardiovascular events, including stroke and cardiovascular death [169].…”

Section: Vitamin D Deficiency and Strokementioning

confidence: 99%

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Vitamin D Deficiency and the Risk of Cerebrovascular Disease

Kim

Perrelli

Ragni³

et al. 2020

Antioxidants

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Vitamin D deficiency has been clearly linked to major chronic diseases associated with oxidative stress, inflammation, and aging, including cardiovascular and neurodegenerative diseases, diabetes, and cancer. In particular, the cardiovascular system appears to be highly sensitive to vitamin D deficiency, as this may result in endothelial dysfunction and vascular defects via multiple mechanisms. Accordingly, recent research developments have led to the proposal that pharmacological interventions targeting either vitamin D deficiency or its key downstream effects, including defective autophagy and abnormal pro-oxidant and pro-inflammatory responses, may be able to limit the onset and severity of major cerebrovascular diseases, such as stroke and cerebrovascular malformations. Here we review the available evidence supporting the role of vitamin D in preventing or limiting the development of these cerebrovascular diseases, which are leading causes of disability and death all over the world.

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“…In a rat stroke model, there was no neuroprotection observed after 5 days of vitamin D treatment after injury [55]; however, adult human studies have shown vitamin D supplementation after stroke decreased mortality, disability, and stroke symptoms [56, 57]. When assessing neonatal brain injury, a study utilizing a rat model of HIE administered calcitriol 30 min after injury, and demonstrated smaller brain lesions in the treated group than in the untreated group.…”

Section: Vitamin D and The Injured Brainmentioning

confidence: 99%

Vitamin D and Its Role in Neonatal Hypoxic-Ischemic Brain Injury

Stessman

Peeples

2018

Neonatology

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Emerging evidence has demonstrated that vitamin D plays an important role in many adult neurologic disorders, but is also critical in neuronal development and pruning in the neonatal and pediatric populations. Neonates are at a particularly high risk of vitamin D deficiency, in part due to the high prevalence of maternal deficiency during pregnancy. Several preclinical studies have demonstrated that infants born to vitamin D-deficient mothers are at a high risk of developing neonatal brain injury, and recent clinical studies have shown that neonates with hypoxic-ischemic encephalopathy (HIE) tend to be vitamin D-deficient. There are limited data, however, on whether additional prenatal or postnatal supplementation may alter the prevalence or severity of neonatal HIE. This review examines the current data supporting the neuroprotective role of vitamin D, with a focus on how these findings may be translated to neonates with HIE.

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Role of Vitamin D in the Outcome of Ischemic Stroke- A Randomized Controlled Trial

Cited by 40 publications

References 35 publications

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Vitamin D Deficiency and the Risk of Cerebrovascular Disease

Vitamin D and Its Role in Neonatal Hypoxic-Ischemic Brain Injury

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