title: Serum 25-hydroxyvitamin d deficiency in ischemic stroke and subtypes in Indian patients.
abstract: OBJECTIVE
  Vitamin D deficiency is common across all age groups and may contribute to cardiovascular diseases. Serum 25-hydroxyvitamin D deficiency causing ischemic stroke has been documented in recent reports.
  
  
  OBJECTIVE
  To investigate the association of serum 25-hydroxyvitamin D deficiency with ischemic stroke and subtypes.
  
  
  METHODS
  We recruited 250 consecutive ischemic stroke patients and 250 age and sex matched controls attending the Department of Neurology, at Yashoda hospital, Hyderabad, India, from January 2011 to December 2012. All ischemic stroke patients underwent stroke subtyping. We measured 25-hydroxyvitamin D by chemiluminescence test, serum calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP) in cases and controls.
  
  
  RESULTS
  Out of 250 stroke patients, 190 (76%) were men and mean age was 58.4±11.1 years (age range-26-89 years). 25-hydroxyvitamin D deficiency was observed in 122 (48.8%) stroke patients and 79 (31.6%) controls (P=0.001). Among stroke patients, serum 25-hydroxyvitamin D deficiency was found in 54.9% (50/91) of patients with large artery atherosclerosis, 54% (20/37) in cardioembolic stroke, 44.4% (20/45) in small artery diseases, 42.8% (15/35) in stroke of other determined etiology and 40.4% (17/42) in stroke of un-determined etiology. Multiple logistic regression analysis showed an independent association of 25-hydroxyvitamin D deficiency with ischemic stroke (odds ratio: 1.6; 95% CI 1.2-2.8). The association was strongest with large artery atherosclerosis (odds ratio: 2.4; 95% CI 1.6-3.5) and cardioembolic stroke (odds ratio: 2.0; 95% CI 1.0-3.2).
  
  
  CONCLUSIONS
  We found that 25-hydroxyvitamin D deficiency had an independent association with ischemic stroke. The association was established in large artery arthrosclerosis and cardioembolic stroke.
authors.affiliation: Department of Neurology, Yashoda Hospital, Hyderabad, India.
authors.forename: Jaydip Ray
authors.initials: JR
authors.lastname: Chaudhuri
authors.affiliation: Department of Neurology, Nizam's Institution of Medical Sciences, Hyderabad, India.
authors.forename: K Rukmini
authors.initials: KR
authors.lastname: Mridula
authors.affiliation: Department of Neurology, Nizam's Institution of Medical Sciences, Hyderabad, India.
authors.forename: Suvarna
authors.initials: S
authors.lastname: Alladi
authors.affiliation: Department of Biochemistry, Yashoda Hospital, Hyderabad, India.
authors.forename: A
authors.initials: A
authors.lastname: Anamika
authors.affiliation: Department of Radiology, Yashoda Hospital Hyderabad, India.
authors.forename: M
authors.initials: M
authors.lastname: Umamahesh
authors.affiliation: Department of Medicine, Yashoda Hospital, Hyderabad, India.
authors.forename: Banda
authors.initials: B
authors.lastname: Balaraju
authors.affiliation: Department of Neurology, Yashoda Hospital, Hyderabad, India.
authors.forename: A
authors.initials: A
authors.lastname: Swath
authors.affiliation: Department of Neurology, Yashoda Hospital, Hyderabad, India. ; Department of Clinical Research, Yashoda Hospital, Hyderabad, India.
authors.forename: Vcs Srinivasarao
authors.initials: VS
authors.lastname: Bandaru
keywords: 25-hyderoxyvitamin D; Indian patients; Ischemic stroke; Stroke subtypes
references.citation: J Hypertens. 2012 Feb;30(2):284-9
references.pmid: 22179077
references.citation: Indian J Med Res. 2011 Mar;133:267-73
references.pmid: 21441679
references.citation: Eur Heart J. 2000 Apr;21(8):639-46
references.pmid: 10731401
references.citation: Circulation. 1997 Sep 16;96(6):1755-60
references.pmid: 9323058
references.citation: Stroke. 2012 Jun;43(6):1470-7
references.pmid: 22442173
references.citation: Am J Prev Med. 1985 Nov-Dec;1(6):9-14
references.pmid: 3870927
references.citation: Nephrol Dial Transplant. 2012 Dec;27 Suppl 4:iv47-52
references.pmid: 23258811
references.citation: Stroke. 2001 Apr;32(4):917-24
references.pmid: 11283392
references.citation: J Clin Invest. 1987 Jun;79(6):1659-64
references.pmid: 2884234
references.citation: J Bone Miner Res. 2004 May;19(5):752-8
references.pmid: 15068498
references.citation: BMC Clin Pathol. 2011 Aug 04;11:8
references.pmid: 21816088
references.citation: J Clin Invest. 1985 Oct;76(4):1536-8
references.pmid: 2997282
references.citation: Am J Cardiol. 2008 Dec 1;102(11):1540-4
references.pmid: 19026311
references.citation: Stroke. 1993 Jan;24(1):35-41
references.pmid: 7678184
references.citation: Atherosclerosis. 2009 Jul;205(1):255-60
references.pmid: 19091317
references.citation: Stroke. 1995 Mar;26(3):361-7
references.pmid: 7886707
references.citation: Arch Intern Med. 2008 Jun 9;168(11):1174-80
references.pmid: 18541825
references.citation: J Clin Invest. 2002 Jul;110(2):229-38
references.pmid: 12122115
references.citation: J Biol Chem. 2004 Aug 20;279(34):35798-802
references.pmid: 15205460
references.citation: Clin Sci (Lond). 1990 Apr;78(4):383-9
references.pmid: 2160356
references.citation: Am J Clin Nutr. 2000 Aug;72(2):472-5
references.pmid: 10919943
references.citation: Calcif Tissue Int. 1987 Aug;41(2):112-4
references.pmid: 2820558
references.citation: J Am Soc Nephrol. 2009 Aug;20(8):1805-12
references.pmid: 19443637
references.citation: N Engl J Med. 2007 Jul 19;357(3):266-81
references.pmid: 17634462
references.citation: Lancet. 1973 Apr 28;1(7809):907-10
references.pmid: 4123837
references.citation: J Am Coll Cardiol. 2008 Dec 9;52(24):1949-56
references.pmid: 19055985
references.citation: Am J Clin Nutr. 2007 Apr;85(4):1062-7
references.pmid: 17413106
references.citation: Stroke. 2008 Sep;39(9):2611-3
references.pmid: 18635847
references.citation: Curr Opin Clin Nutr Metab Care. 2008 Jan;11(1):7-12
references.pmid: 18090651
references.citation: Stroke. 2011 Aug;42(8):2240-5
references.pmid: 21719770
references.citation: Stroke. 2006 Jan;37(1):243-5
references.pmid: 16322500
references.citation: Am J Epidemiol. 2009 Oct 15;170(8):1032-9
references.pmid: 19762371
references.citation: PLoS One. 2013 Jul 25;8(7):e69080
references.pmid: 23935930
references.citation: Stroke. 2000 Oct;31(10):2385-9
references.pmid: 11022068
references.citation: Atherosclerosis. 1995 Sep;117(1):125-38
references.pmid: 8546749
references.citation: J Bone Miner Metab. 2005;23(2):147-51
references.pmid: 15750693
references.citation: J Neurol. 2009 Dec;256(12):2003-8
references.pmid: 19609738
references.citation: Arch Intern Med. 2007 Jun 11;167(11):1159-65
references.pmid: 17563024
references.citation: Pharmacotherapy. 2009 Jun;29(6):691-708
references.pmid: 19476421
references.citation: Kardiologiia. 2003;43(11):93-7
references.pmid: 14671565
references.citation: Neurology. 2010 Jan 5;74(1):18-26
references.pmid: 19940273
references.citation: J Am Coll Cardiol. 2003 Jan 1;41(1):105-12
references.pmid: 12570952
references.citation: Diabetes Res Clin Pract. 2002 Jan;55(1):65-85
references.pmid: 11755481
references.citation: Saudi Med J. 2009 Apr;30(4):509-14
references.pmid: 19370277
references.citation: Endocr Rev. 2001 Aug;22(4):477-501
references.pmid: 11493580
references.citation: Neurology. 2010 Nov 30;75(22):1995-2002
references.pmid: 21115954
references.citation: Monatsschr Kinderheilkd. 1989 Feb;137(2):108-10
references.pmid: 2716737