title: Association between Admission Serum 25-Hydroxyvitamin D Levels and Functional Outcome of Thrombolyzed Stroke Patients.
abstract: BACKGROUND
  25-Hydroxyvitamin D (25(OH)D) deficiency is a frequent condition in patients who suffer a stroke, and several studies suggested that it may be associated with a poorer prognosis. The aim of this study was to investigate specifically the association between 25(OH)D levels and functional outcome at 3 months in ischemic stroke patients treated with intravenous thrombolysis.
  
  
  METHODS
  Consecutive ischemic stroke patients who received intravenous thrombolysis were enrolled between 2010 and 2013. Baseline characteristics were collected, and serum concentrations of 25(OH)D were measured within the first 24 hours after admission and were analyzed according to the quartiles of their distribution (<25 nmol/L versus ≥ 25 nmol/L). Multivariable ordinal logistic regression was used to evaluate the association between 25(OH)D and 3-month functional outcome assessed by the modified Rankin score.
  
  
  RESULTS
  Three hundred fifty-two patients were included (mean age 68.6 ± 15.8, 50.7% women, mean 25(OH)D level 45 ± 25 nmol/L). The characteristics of the patients only differed with regard to higher premorbid functional impairment in patients with low 25(OH)D. In univariate analysis, the risk of functional impairment in patients with low 25(OH)D levels was greater than that in patients with higher 25(OH)D levels (odds ratio [OR] 2.10, 95% confidence interval [CI]: 1.35-3.27, P = .001). This association was still observed after adjustment for confounding variables (OR 1.70, 95% CI: 1.06-2.71, P = .027).
  
  
  CONCLUSIONS
  A low serum 25(OH)D level is associated with worse functional outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. Further investigations are required to understand the underlying mechanisms of this association.
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Daumas
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Daubail
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Legris
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Jacquin-Piques
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Sensenbrenner
authors.affiliation: Biochimie Spécialisée, Pôle Technique de Biologie, University Hospital of Dijon, Dijon, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Denimal
authors.affiliation: Biochimie Spécialisée, Pôle Technique de Biologie, University Hospital of Dijon, Dijon, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Lemaire-Ewing
authors.affiliation: Biochimie Spécialisée, Pôle Technique de Biologie, University Hospital of Dijon, Dijon, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Duvillard
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.affiliation: Department of Neurology and Dijon Stroke Registry, EA4184, University Hospital and Medical School of Dijon, University of Bourgogne Franche-Comté, Dijon, France. Electronic address: ybejot@yahoo.fr.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
mesh_terms: D061605:Administration, Intravenous; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D005343:Fibrinolytic Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D010959:Tissue Plasminogen Activator
keywords: Stroke; prognosis; thrombolysis; vitamin D