LU Zhenhui, GUO Xiaoming, LI Xinling, CAO Zhiyong, ZHU Lianha, ZHU Xiangyang. Effect of serum 25-hydroxyvitamin D3 level on cognitive function after stroke in elderly patients with first-episode cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2021, 25(17): 61-66. DOI: 10.7619/jcmp.20211950
Citation: LU Zhenhui, GUO Xiaoming, LI Xinling, CAO Zhiyong, ZHU Lianha, ZHU Xiangyang. Effect of serum 25-hydroxyvitamin D3 level on cognitive function after stroke in elderly patients with first-episode cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2021, 25(17): 61-66. DOI: 10.7619/jcmp.20211950

Effect of serum 25-hydroxyvitamin D3 level on cognitive function after stroke in elderly patients with first-episode cerebral infarction

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  • Received Date: May 10, 2021
  • Available Online: August 09, 2021
  • Published Date: September 14, 2021
  •   Objective  To investigate the effect of serum 25-hydroxyvitamin D3[25(OH)D3] on cognitive function after stroke in elderly patients with with first-episode ischemic stroke.
      Methods  A total of 270 elderly patients with first-episode cerebral infarction were selected as study subjects. The National Institutes of Health Stroke Scale (NIHSS) scores and Montreal Cognition Scale (MoCA) scores were assessed at admission. The follow-up period lasted 6 months, and the MoCA score was re-measured at 3 months, and the modified Rankin Scale (mRS) score was assessed at 6 months. According to the MoCA score at 3 months, the patients were divided into early post-stroke cognitive impairment (PSCI) group and early post-stroke cognitive normal (non-PSCI) group, and the clinical data of the two groups was compared. Logistic regression analysis was used to determine the independent influencing factors of early PSCI in elderly patients with first-episode cerebral infarction. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum 25(OH)D3 level on early PSCI in elderly patients with first-episode cerebral infarction. Patients were further divided into low VD group and normal VD group according to the serum 25(OH)D3 cut-off value, and the early PSCI incidence and MoCA scores between the two groups were compared.
      Results  Among 270 patients, the incidence rate of early PSCI was as high as 60.37% (163/270). Serum 25(OH)D3 level was an independent influencing factor for early PSCI in elderly patients with first-episode acute cerebral infarction(OR=0.834, 95%CI, 0.766 to 0.907, P < 0.001). The correlation between serum 25(OH)D3 level and early cognitive function after cerebral infarction was stronger in female patients than in males. The area under ROC curve of serum 25(OH)D3 in predicting early PSCI of elderly patients with first-episode cerebral infarction was 0.751 (P < 0.05), and the best cutoff value was 23.17 ng/mL. The incidence of early PSCI in low VD group was higher than that in normal VD group, and the MoCA score was lower than that in normal VD group, the difference was statistically significant (P < 0.05).
      Conclusion  Normal serum 25(OH)D3 is an independent protective factor for early PSCI in elderly patients with first-episode cerebral infarction. Serum 25(OH)D3 level can affect the cognitive function after stroke in elderly patients with first-episode cerebral infarction, and its effect on the cognitive function after stroke is greater in elderly women than elderly men.
  • [1]
    WANG Y J, ZHU J G, DELUCA H F. Where is the vitamin D receptor[J]. Arch Biochem Biophys, 2012, 523(1): 123-133. doi: 10.1016/j.abb.2012.04.001
    [2]
    OWUSU J E, ISLAM S, KATUMULUWA S S, et al. Cognition and Vitamin D in Older African-American Women-Physical performance and Osteoporosis prevention with vitamin D in older African Americans Trial and Dementia[J]. J Am Geriatr Soc, 2019, 67(1): 81-86. doi: 10.1111/jgs.15607
    [3]
    JORDE R, KUBIAK J, SVARTBERG J, et al. Vitamin D supplementation has no effect on cognitive performance after four months in mid-aged and older subjects[J]. J Neurol Sci, 2019, 396: 165-171. doi: 10.1016/j.jns.2018.11.020
    [4]
    PULLICINO P M, PORDELL R. Computed tomography and magnetic resonance of subcortical ischemic lesions[J]. Adv Neurol, 1993, 62: 73-92. http://www.ncbi.nlm.nih.gov/pubmed/8517213
    [5]
    SCHELTENS P, LAUNER L J, BARKHOF F, et al. Visual assessment of medial temporal lobe atrophy on magnetic resonance imaging: interobserver reliability[J]. J Neurol, 1995, 242(9): 557-560. doi: 10.1007/BF00868807
    [6]
    FAZEKAS F, CHAWLUK J B, ALAVI A, et al. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging[J]. AJR Am J Roentgenol, 1987, 149(2): 351-356. doi: 10.2214/ajr.149.2.351
    [7]
    PARK M H. Informant questionnaire on cognitive decline in the elderly (IQCODE) for classifying cognitive dysfunction as cognitively normal, mild cognitive impairment, and dementia[J]. Int Psychogeriatr, 2017, 29(9): 1461-1467. doi: 10.1017/S1041610217000965
    [8]
    PINTO T C C, MACHADO L, BULGACOV T M, et al. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) in the elderly[J]. Int Psychogeriatr, 2019, 31(4): 491-504. doi: 10.1017/S1041610218001370
    [9]
    JOKINEN H, MELKAS S, YLIKOSKI R, et al. Post-stroke cognitive impairment is common even after successful clinical recovery[J]. Eur J Neurol, 2015, 22(9): 1288-1294. doi: 10.1111/ene.12743
    [10]
    JOLLIFFE D A, HANIFA Y, WITT K D, et al. Environmental and genetic determinants of vitamin D status among older adults in London, UK[J]. J Steroid Biochem Mol Biol, 2016, 164: 30-35. doi: 10.1016/j.jsbmb.2016.01.005
    [11]
    成乐, 赵海峰. 中国老年人维生素D摄入与认知障碍防治进展[J]. 中华疾病控制杂志, 2020, 24(5): 602-606. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ202005021.htm
    [12]
    JIA J Y, HU J, HUO X X, et al. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer′s disease: a randomised, double-blind, placebo-controlled trial[J]. J Neurol Neurosurg Psychiatry, 2019, 90(12): 1347-1352. http://jnnp.bmj.com/content/early/2019/07/11/jnnp-2018-320199.full
    [13]
    YAMINI P, RAY R S, CHOPRA K. Vitamin D3 attenuates cognitive deficits and neuroinflammatory responses in ICV-STZ induced sporadic Alzheimer′s disease[J]. Inflammopharmacology, 2018, 26(1): 39-55. doi: 10.1007/s10787-017-0372-x
    [14]
    GUO X, YUAN J, WANG J, et al. Calcitriol alleviates global cerebral ischemia-induced cognitive impairment by reducing apoptosis regulated by VDR/ERK signaling pathway in rat Hippocampus[J]. Brain Res, 2019, 1724: 146430. doi: 10.1016/j.brainres.2019.146430
    [15]
    GARBOSSA S G, FOLLI F. Vitamin D, sub-inflammation and insulin resistance. A window on a potential role for the interaction between bone and glucose metabolism[J]. Rev Endocr Metab Disord, 2017, 18(2): 243-258. doi: 10.1007/s11154-017-9423-2
    [16]
    ZHANG C E, WONG S M, UITERWIJK R, et al. Intravoxel incoherent motion imaging in small vessel disease: microstructural integrity and microvascular perfusion related to cognition[J]. Stroke, 2017, 48(3): 658-663. doi: 10.1161/STROKEAHA.116.015084
    [17]
    RENSMA S P, VAN SLOTEN T T, HOUBEN A J H M, et al. Microvascular dysfunction is associated with worse cognitive performance: the maastricht study[J]. Hypertension, 2020, 75(1): 237-245. doi: 10.1161/HYPERTENSIONAHA.119.13023
    [18]
    LIU L L, ZHANG C, LV X, et al. Sex-specific associations between lipids and cognitive decline in the middle-aged and elderly: a cohort study of Chinese adults[J]. Alzheimer′s Res Ther, 2020, 12(1): 164. doi: 10.1186/s13195-020-00731-1
    [19]
    OJALA-OKSALA J, JOKINEN H, KOPSI V, et al. Educational history is an independent predictor of cognitive deficits and long-term survival in postacute patients with mild to moderate ischemic stroke[J]. Stroke, 2012, 43(11): 2931-2935. doi: 10.1161/STROKEAHA.112.667618
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