title: The effect of cigarette smoking on vitamin D level and depression in male patients with acute ischemic stroke.
abstract: OBJECTIVE
  The association between low vitamin D levels and depression has been well documented in nonstroke subjects. Accumulating evidence shows that low vitamin D levels may be also associated with depression post stroke. Cigarette smoking was associated with lower vitamin D levels. The purposes of this study were to compare vitamin D levels in smokers to nonsmokers and examine the association between vitamin D levels and depression symptoms in patients with acute ischemic stroke.
  
  
  METHODS
  Serum levels of 25-hydroxyvitamin D [25(OH)D] were measured in 194 males within 24h after admission: 116 smokers and 78 nonsmokers. Depression symptoms were assessed with the 17-item Hamilton Depression Scale (HAMD-17). Patients with the HAMD-17 score >7 were identified to have depression symptoms.
  
  
  RESULTS
  The chi-square test showed that the frequency of depression in the smoker group was 23.3% (27/116), which was significantly higher than that in the nonsmoker group (11.5%=9/78), with an odds ratios (OR) of 2.33 (95% CI: 1.03-5.27; χ(2)=4.25, df=1, p=0.039, φ=0.15). Vitamin D levels were significantly lower in smokers than in nonsmokers (52.4±20.8 vs 61.7±19.2; F=9.88, p=0.002), with an effect size of 0.05 (ηp(2)). Patients with depression symptoms showed lower vitamin D levels than those with no depression symptoms (49.2±19.6 vs 57.7±20.6; F=5.03, p=0.03), with an effect size of 0.03 (ηp(2)).
  
  
  CONCLUSIONS
  Higher rates of depression in smokers with acute ischemic stroke may be associated with lower vitamin D levels induced by smoking.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wenwei
authors.initials: W
authors.lastname: Ren
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Mengjiao
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: hjc@wmu.edu.cn.
authors.forename: Jincai
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications*; D003863:Depression / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D020521:Stroke / Q000150:complications* / Q000209:etiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D