The Association Between Inflammatory Biomarkers and Vitamin D Level With Evolution and Severity of Stroke

Background and purpose: Vitamin D deficiency has been shown to be linked to evolution of ischemic stroke, but the data regarding the association between stroke severity and vitamin D level is scarce. Materials and methods: Patients with first-ever acute ischemic stroke in the middle cerebral artery (MCA) territory within 7 days after the stroke were recruited. The control group included age and gender matched individuals. We compared 25-OH vitamin D (vitamin D), high sensitive C-reactive protein (hsCRP), serum amyloid A (SAA), and osteopontin levels between stroke patients and the control group. We also investigated the association between stroke severity according to National Institutes of Health Stroke Scale (NIHSS) and Alberta stroke program early CT score (ASPECTS) and vitamin D level as well as inflammatory biomarkers. Results: Current study showed the association between hypertension (P= 0.035), diabetes mellitus (P= 0.043), smoking (P= 0.016), history of ischemic heart disease (P= 0.002), higher SAA (P< 0.001), higher hsCRP (P< 0.001), and lower vitamin D levels (P= 0.002) with stroke evolution in a case-controlled study. Meanwhile, in stroke patients, its severity was associated with higher SAA (P= 0.04), higher hsCRP (P= 0.001), and lower vitamin D levels (P value= 0.043) according to clinical scale (higher admission NIHSS). According to ASPECT score, higher SAA (P= 0.017), higher hsCRP (P= 0.007), but not lower vitamin D level were associated with more infarct areas (P= 0.149). Conclusion:  Vitamin D might have a role in both evolution and severity of stroke.