25-Hydroxyvitamin D and symptomatic ischemic stroke: An Original Study and Meta-Analysis

• Published in: Annals of neurology 2013-01, Vol.73 (1), p.38-47
• Main Authors: Brøndum-Jacobsen, Peter, Nordestgaard, Børge G., Schnohr, Peter, Benn, Marianne
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Brain Ischemia - blood; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Confidence intervals; Denmark - epidemiology; Female; Follow-Up Studies; Humans; Male; Meta-analysis; Middle Aged; Plasma; Population; Population Surveillance - methods; Prospective Studies; Risk Factors; Stroke; Stroke - blood; Stroke - diagnosis; Stroke - epidemiology; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin deficiency
• ISSN: 0364-5134; 1531-8249
• DOI: 10.1002/ana.23738

Objective: We tested the hypothesis that low plasma concentrations of 25‐hydroxyvitamin D are associated with increased risk of symptomatic ischemic stroke in the general population. Methods: We measured plasma 25‐hydroxyvitamin D in 10,170 individuals from the general population, the Copenhagen City Heart Study. During 21 years of follow‐up, 1,256 and 164 persons developed ischemic and hemorrhagic stroke, respectively. In a meta‐analysis of ischemic stroke, we included 10 studies, 58,384 participants, and 2,644 events. Results: Stepwise decreasing plasma 25‐hydroxyvitamin D concentrations were associated with stepwise increasing risk of ischemic stroke both as a function of seasonally adjusted percentile categories and as a function of clinical categories of 25‐hydroxyvitamin D (p for trend ≤ 2 × 10−3). In a Cox regression model comparing individuals with plasma 25‐hydroxyvitamin D concentrations between the 1st and 4th percentiles to individuals with 25‐hydroxyvitamin D concentrations between the 50th and 100th percentiles, multivariate adjusted hazard ratio of ischemic stroke was 1.82 (95% confidence interval, 1.41–2.34). Comparing individuals with clinical categories of severe vitamin D deficiency (