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Factors Related to Hypovitaminosis D in Persons with Ischemic Stroke

Tongsephee R, MD¹, Manimmanakorn N, MD, PhD¹, Vichiansiri R, MD¹, Manimmanakorn A, PhD², Amatya B, DocMedSci, MPH, MD³, Khan F, MBBS, MD, FARM (RACP)³

Affiliation : ¹ Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ² Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ³ Department of Rehabilitation Medicine, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia

Background: Low Vitamin D level can be related to malfunction of various organs. Information on prevalence of hypovitaminosis D and related factors is important to improve quality of stroke management including rehabilitation.
Objective: To evaluate the prevalence of hypovitaminosis D and related factors in acute stroke patients.
Materials and Methods: Cross sectional study was conducted at Srinagarind Hospital, Khon Kaen, a tertiary referral center of the acute stroke patients, admitted between January and June 2017.
Results: Ninety-six acute stroke patients were included in the present study. Most were males (n=61, 64%) with mean age of 65±12 years. The prevalence of hypovitaminosis D was 54.17% (95% CI 44.23 to 64.14). Factors related to hypovitaminosis D were female, indoor activities, duration of sunlight exposure less than 30 minute a day, frequency of sunlight exposure less than two times a week, regular sunscreen use, and area of application. In addition, vitamin D levels were negatively correlated with the severity of stroke (National Institutes of Health Stroke Scale, NIHSS) (r=–0.227, p=0.026), and positively correlated with ability to perform daily activities (Barthel index, r=0.242, p=0.017). There was no significant correlation between hypovitaminosis D and other factors such as age, body mass index, co-morbidities, Thai Mental State Examination (TMSE) score, and high vitamin D diet consumption.
Conclusion: Hypovitaminosis D was found to be highly prevalent in acute stroke patients. Main factors that significantly affected vitamin D levels were female and inadequate sunlight exposure. Vitamin D levels should be routinely evaluated in stroke patients.

Keywords : Cerebrovascular accident, Functional outcome, Prevalence, Vitamin D deficiency


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