title: Serum 25-hydroxyvitamin D deficiency predicts poor outcome amongst acute ischaemic stroke patients with low high density lipoprotein cholesterol.
abstract: Current observational studies indicate that a lower vitamin D level is associated with a higher risk of poor ischaemic stroke prognosis. Whether this association is affected by lipid levels is unclear. Our aim was to examine the effect of serum vitamin D especially its deficiency on the global outcome of ischaemic stroke stratified by individual lipid component level.
  
  
  
  A total of 3181 ischaemic patients from China Antihypertensive Trial in Acute Ischaemic Stroke were included in this study and their baseline serum 25-hydroxyvitamin D levels were tested. They were prospectively followed up for death, major disability and vascular events for 3 months after acute ischaemic stroke. A multivariable logistic model was used to evaluate the association between serum 25-hydroxyvitamin D levels and clinical outcomes of ischaemic stroke in the 3-month period of follow-up in all patients and in different lipid-level subgroups.
  
  
  
  Vitamin D deficiency was associated with poor clinical outcomes only in ischaemic stroke patients with high density lipoprotein cholesterol (HDLC) <1.04 mmol/l rather than all patients. The multivariable adjusted odds ratios (95% confidence intervals) of major disability and composite adverse events were 1.98 (1.08-3.63) and 2.24 (1.22-4.12), respectively. There was a significant interaction effect between vitamin D and HDLC levels on major disability and the composite outcome (P for interaction < 0.05 for both). A significant linear trend existed between 25-hydroxyvitamin D and risk of poor prognosis (P = 0.03).
  
  
  
  Vitamin D deficiency may be merely an independent risk factor of poor prognosis in ischaemic stroke patients with low HDLC level.
authors.affiliation: Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.|Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
authors.forename: T
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
authors.forename: C
authors.initials: C
authors.lastname: Zhong
authors.affiliation: Department of Neurology, Affiliated Hospital of Hebei United University, Hebei, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: C-S
authors.initials: CS
authors.lastname: Chen
authors.affiliation: Department of Neurology, Yutian County Hospital, Hebei, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Ju
authors.affiliation: Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China.
authors.forename: D
authors.initials: D
authors.lastname: Geng
authors.affiliation: Department of Cardiology, First Affiliated Hospital of China Medical University, Liaoning, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Neurology and Cardiology, Dongping County People's Hospital, Dongping, Shandong, China.
authors.forename: D
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Wenshang County Hospital of Traditional Chinese Medicine, Shandong, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.|Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.|Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: J
authors.initials: J
authors.lastname: He
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood / Q000150:complications*; D002681:China; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D008076:Cholesterol, HDL; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: high density lipoprotein cholesterol; ischaemic stroke; prognosis; vitamin D