The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

Marek, Klaudia; Cichoń, Natalia; Saluk‐Bijak, Joanna; Bijak, Michał; Miller, Elżbieta

doi:10.3390/nu14132761

Cited by 14 publications

(7 citation statements)

References 123 publications

(153 reference statements)

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“…67 Beyond the existing research focused on cardiovascular disease outlined above, a number of prior studies specifically evaluated the role of vitamin D in stroke. 68 Zhou et al 69 investigated the relationship between vitamin D and stroke in a meta-analysis that pooled results from 19 cohort and case/control studies, finding that lower vitamin D levels were associated with a higher risk of IS. Similarly, a single-center, prospective observational study that evaluated 349 patients with first-ever IS found that lower vitamin D levels were associated with higher risk of early stroke recurrence.…”

Section: Discussionmentioning

confidence: 99%

Whole-Exome Sequencing Analyses Support a Role of Vitamin D Metabolism in Ischemic Stroke

Xie

Acosta

et al. 2023

Stroke

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BACKGROUND: Ischemic stroke (IS) is a highly heritable trait, and genome-wide association studies have identified several commonly occurring susceptibility risk loci for this condition. However, there are limited data on the contribution of rare genetic variation to IS. METHODS: We conducted an exome-wide study using whole-exome sequencing data from 152 058 UK Biobank participants, including 1777 IS cases. We performed single-variant analyses for rare variants and gene-based analyses for loss-of-function and deleterious missense rare variants. We validated these results through (1) gene-based testing using summary statistics from MEGASTROKE—a genome-wide association study of IS that included 67 162 IS cases and 454 450 controls, (2) gene-based testing using individual-level data from 1706 IS survivors, including 142 recurrent IS cases, enrolled in the VISP trial (Vitamin Intervention for Stroke Prevention); and (3) gene-based testing against neuroimaging phenotypes related to cerebrovascular disease using summary-level data from 42 310 UK Biobank participants with available magnetic resonance imaging data. RESULTS: In single-variant association analyses, none of the evaluated variants were associated with IS at genome-wide significance levels ( P <5×10 −8 ). In the gene-based analysis focused on loss-of-function and deleterious missense variants, rare genetic variation at CYP2R1 was significantly associated with IS risk ( P =2.6×10 −6 ), exceeding the Bonferroni-corrected threshold for 16 074 tests ( P <3.1×10 −6 ). Validations analyses indicated that CYP2R1 was associated with IS risk in MEGASTROKE (gene-based test, P =0.003), with IS recurrence in the VISP trial (gene-based test, P =0.001) and with neuroimaging traits (white matter hyperintensity, mean diffusivity, and fractional anisotropy) in the UK Biobank neuroimaging study (all gene-based tests, P <0.05). CONCLUSIONS: Because CYP2R1 plays an important role in vitamin D metabolism and existing observational evidence suggests an association between vitamin D levels and cerebrovascular disease, our results support a role of this pathway in the occurrence of IS.

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Section: Discussionmentioning

confidence: 99%

Whole-Exome Sequencing Analyses Support a Role of Vitamin D Metabolism in Ischemic Stroke

Xie

Acosta

et al. 2023

Stroke

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“…In respect of the impact of vitamin D supplementation on symptoms of depression, the findings of previous studies in the non-stroke population remained inconsistent (66-68) and there were no relevant studies focusing on PSD. Nevertheless, there was evidence showing an association of vitamin D supplementation with better rehabilitation outcomes in patients diagnosed with stroke (69). Accordingly, this approach may still be recommended for this patient population despite the lack of evidence supporting the beneficial effects of vitamin D supplementation on PSD.…”

Section: Discussionmentioning

confidence: 99%

Association of a low vitamin D status with risk of post-stroke depression: A meta-analysis and systematic review

Hung

Wu²,

Illias³

et al. 2023

Front. Nutr.

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BackgroundAlthough post-stroke depression (PSD) affects one-third of patients following an acute stroke, pooled evidence addressing the correlation between a low vitamin D status and the risk of PSD remains inconclusive.MethodsComprehensive database search of Medline, EMBASE, Cochrane library, and Google Scholar was performed from inception to December 2022. The primary outcome was the association of PSD risk with a low vitamin D status, while the secondary outcomes included the relationship between PSD and other risk factors.ResultsAnalysis of seven observational studies published between 2014 and 2022 with 1,580 patients showed pooled incidences of vitamin D deficiency (defined as 25[OH] D levels < 50 nmol/L) and PSD of 60.1 and 26.1%, respectively. Patients with PSD had a lower circulating vitamin D concentration compared to those without [mean difference (MD) =−13.94 nmol/L, 95% CI: −21.83 to −6.05, p = 0.0005, I2 = 91%, six studies, 1,414 patients]. Meta-analysis also demonstrated a correlation between a low vitamin D level and an increased PSD risk [odd ratio (OR) = 3.25, 95% CI: 1.57–6.69, p = 0.001, I2 = 78.7%, 1,108 patients], the heterogeneity of which was found to be associated with the incidence of vitamin D deficiency but not female proportion on meta-regression. Besides, female gender (OR = 1.78, 95% CI: 1.3–2.44, p = 0.003, I2 = 31%, five studies, 1,220 patients), hyperlipidemia (OR = 1.55, 95% CI: 1.01–2.36, p = 0.04, I2 = 0%, four studies, 976 patients), and high National Institutes of Health Stroke Scale (NIHSS) scores (MD = 1.45, 95% CI: 0.58–2.32, p = 0.001, I2 = 82%, five studies, 1,220 patients) were potential risk factors for PSD. For the primary outcome, the certainty of evidence was very low. Regarding secondary outcomes, the certainty of evidence was low for BMI, female gender, hypertension, diabetes, and stroke history, and very low for age, level of education, hyperlipidemia, cardiovascular disease, and NIHSS scores.ConclusionThe results suggested an association of a low circulating vitamin D level with an increased risk of PSD. Besides, female gender, hyperlipidemia, high NIHSS score were related to an increased risk or occurrence of PSD. The current study may imply the necessity of routine circulating vitamin D screening in this population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022381580.

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“…19 Hypovitaminosis-D has a greater risk of stroke in literature. 20,21 Vitamin D may help to prevent neurodegenerative diseases of aging through protection against ischemia. Also, Fazekas-3 group had more subjects with hypertension in the present study.…”

Section: Discussionmentioning

confidence: 99%

The importance of Vitamin-D and Neutrophil-Lymphocyte Ratio for Alzheimer’s Disease

Evlice¹,

Şanlı²,

Boz³

2023

Pak J Med Sci

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Objective: Ischemia and inflammation play a role in the pathophysiology of Alzheimer’s disease (AD). Plasma neutrophil–lymphocyte ratio (NLR), and 25- hydroxyvitamin D (vitamin D) were used as a biomarker for inflammation and atherosclerosis. The present study aimed to investigate a link between NLR, vitamin D and ischemia in AD. Methods: The subjects with AD and control groups were enrolled to this retrospective study between 2017-2022 at Cukurova University Hospital. The cognitive assessment (MMSE), and blood tests (NLR, vitamin D) were collected from all subjects. In first part of the study, AD (n:132) and the control group (n:38) were compared. In second part of the study, magnetic resonance imaging (MRI) was used for evaluating ischemic lesions with scoring method of Fazekas. The control group (n:38) and AD subjects with mild ischemic lesions (Fazekas-1 and Fazekas-2) (n:64) were excluded. AD subjects with severe ischemic lesions (Fazekas-3) (n:34) and without ischemic lesions (Fazekas-0) (n:34) were compared again. SPSS 20.0 was used for all analyses. The threshold for statistical significance was set at 0.05. Results: In the first part of the study, 132 AD patients (69 female and 63 male; mean age 70.83±9.35 (49-87) and age-matched 38 controls were compared. The mean NLR in AD [2.96±2.46 (1.17-19.43)] was higher than the control group [1.9±0.66 (0.9-3.56)] (p=0.005). In the second part of the study, the mean Vitamin D of Fazekas-3 AD group [16.15±9.64 (4.7-35)] was lower than Fazekas-0 AD group [16.27±6.81(4.6-29.7)] (p=0.024). Conclusion: NLR was higher in AD while there was no difference between the Fazekas-0 and Fazekas-3 AD groups. Vitamin D was lower in the Fazekas-3 AD group. These data suggested that NLR increased independently of ischemia in AD. Also vitamin D deficiency could trigger ischemia in AD. doi: https://doi.org/10.12669/pjms.39.3.7024 How to cite this: Evlice A, Sanli ZS, Boz PB. The importance of Vitamin-D and Neutrophil-Lymphocyte Ratio for Alzheimer’s Disease. Pak J Med Sci. 2023;39(3):799-803. doi: https://doi.org/10.12669/pjms.39.3.7024 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

Cited by 14 publications

References 123 publications

Whole-Exome Sequencing Analyses Support a Role of Vitamin D Metabolism in Ischemic Stroke

Whole-Exome Sequencing Analyses Support a Role of Vitamin D Metabolism in Ischemic Stroke

Association of a low vitamin D status with risk of post-stroke depression: A meta-analysis and systematic review

The importance of Vitamin-D and Neutrophil-Lymphocyte Ratio for Alzheimer’s Disease

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