title: Increased Incidence of Hypovitaminosis D Among Patients Requiring Treatment for Cerebral Aneurysms.
abstract: OBJECTIVE
  Aneurysmal subarachnoid hemorrhage management is hampered by our incomplete understanding of what variables promote aneurysm formation, growth, and rupture. Because hypovitaminosis D has been identified as a risk factor for other vascular diseases, we examined its association with cerebral aneurysms requiring treatment.
  
  
  METHODS
  We retrospectively reviewed charts of patients with cerebral aneurysms with recorded 25-hydroxy vitamin D levels undergoing treatment at our institution from May 2010 to May 2015. We compared these patients with a group of patients without aneurysms. We used multivariable Poisson regression and backward elimination to identify factors associated with cerebral aneurysms, with a threshold P < 0.20. A propensity-matching algorithm was used, incorporating all factors with P < 0.10 in our regression model.
  
  
  RESULTS
  Patients in the aneurysm group were older than those in the control group (P = 0.001) and more likely to be female (P = 0.004), to be tobacco users (P < 0.001), and to have a diagnosis of hypertension (P = 0.001), but ethnicity, body mass index, and diabetes rates did not differ. Vitamin D levels in the aneurysm group were lower than in the control group (23.3 ± 12.3 vs. 28.7 ± 14.1 ng/mL, P = 0.001), and the patients were more likely to be vitamin D deficient (P = 0.028). Multivariable Poisson regression demonstrated that vitamin D level, tobacco use, age, and sex were significantly associated with aneurysms requiring treatment (P < 0.05). The propensity-matching algorithm confirmed a significant difference in vitamin D levels between the aneurysm and control groups (P = 0.01).
  
  
  CONCLUSIONS
  Patients with cerebral aneurysms requiring treatment have a significantly higher incidence of hypovitaminosis D compared with patients in a control group.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Guan
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Karsy
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Eli
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Erica F
authors.initials: EF
authors.lastname: Bisson
authors.affiliation: Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: McNally
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Philipp
authors.initials: P
authors.lastname: Taussky
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA. Electronic address: neuropub@hsc.utah.edu.
authors.forename: Min S
authors.initials: MS
authors.lastname: Park
mesh_terms: D017542:Aneurysm, Ruptured; D015984:Causality; D015897:Comorbidity; D057510:Endovascular Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000097:blood / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014589:Utah / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Aneurysm; Propensity matching; Subarachnoid hemorrhage; Vitamin D