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Impact of Vitamin D Deficiency on Ischemic Stroke Severity: Insights from a Prospective Study
Jibin Simon1, Tirumalasetty Sriharsha1, Ananthakumar Perumal Kumaresan1
1Internal Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Abstract:
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 (β = -0.3994, p < 0.001) after adjusting for age, sex, and comorbidities, with p < 0.05 considered statistically significant. In addition, age (β = 0.1123, p = 0.009) and comorbid conditions (β = 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.
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