Association between Serum 25-Hydroxyvitamin D and Carotid Intima-Media Thickness in Acute Ischaemic Stroke: A Cross-Sectional Study OC20-OC23
Dr. Ajay Kumar Mishra,
Associate Professor, Department of Medicine, Era's Lucknow Medical College, Lucknow-226012, Uttar Pradesh, India.
Introduction: Vitamin D has been shown to have a strong association with both ischaemic stroke and cardiovascular disease. There is a scarcity of published data from Indian subcontinent on vitamin D status and its association with acute ischaemic stroke.
Aim: To study the association between serum 25-hydroxyvitamin D and Carotid Intima-Media Thickness (CIMT) in acute ischaemic stroke.
Materials and Methods: One hundred ten consecutive subjects with acute ischaemic stroke were selected as cases and 55 healthy age and gender match subjects were included as controls. Quantitative measurement of 25-OH vitamin D in serum and plasma samples was done. Common Carotid Artery (CCA) doppler images were obtained to measure Intima-Media Thickness (IMT) by using three different angle views for each vessel. Student’s t-test was used for comparison of continuous variables. The results of comparing the correlation between two continuous variables were indicated by the correlation coefficient (r) using correlation analysis.
Results: In the study population i.e., both in cases and controls, 59.39% subjects had vitamin D insufficiency, 34.44%had vitamin D deficiency and only 6.06% had Vitamin D levels within normal limits. The difference between the mean Vitamin D levels of cases (13.35±5.58 ng/mL) and controls (18.78±9.28 ng/mL) was found to be statistically significant (p<0.001). The difference mean CIMT among the cases (0.09±0.01 mm) and controls (0.07±0.01 mm) was also found to be statistically significant (p<0.001). Correlation between age and vitamin D levels was not statistically significant. A weak statistically significant negative correlation between CIMT and Vitamin D levels was found (r= -0.184 p=0.018).
Conclusion: The findings suggest that there is a probable association between low Vitamin D levels and acute ischaemic stroke. However, in view of presence of numerous confounding factors like diabetes, hypertension and obesity in our study a definite causal relationship cannot be established. Although both Vitamin D levels and CIMT show a strong association with acute ischaemic stroke; the linear relationship between Vitamin D levels and CIMT is rather weak.