The Open Neurology Journal

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Correlation between Serum Vitamin A and D Levels in Acute Phase Ischemic Stroke and Clinical Outcome

Alfansuri Kadri1, *, Hasan Sjahrir1, Rosita J. Sembiring2, Muhammad Ichwan3
1 Neurology Department, Faculty of Medicine, Universitas Sumatera Utara Adam Malik General Hospital, Medan, Indonesia
2 Clnical Pathology Department, Faculty of Medicine, Universitas Sumatera Utara Adam Malik General Hospital, Medan, Indonesia
3 Pharmacology Department, Faculty of Medicine, Universitas Sumatera Utara Adam Malik General Hospital, Medan, Indonesia



In the last decade, a number of studies have examined the relationship between serum vitamin D concentration and the risk of cerebrovascular events. Besides vitamin D, the latest evidence shows that vitamin A is also a risk factor for cerebrovascular disease. Vitamin A and its derivatives act biologically via specific nuclear receptors that regulate gene transcription. Vitamin A receptors can also interact with other nuclear receptors that have neuroprotective effects such as vitamin D, against stroke. Although many studies suggested the synergism of vitamin A and D, there is still no study that evaluates their levels simultaneously in acute phase ischemic stroke, and the relationship to outcome.


The objective of this study was to analyze the correlation between serum vitamin A and D levels on admission in Acute Ischemic Stroke patients and clinical outcome by using the National Institutes of Health Stroke Scale (NIHSS).


A prospective cohort study was conducted, and samples were followed since the diagnosis of acute-phase Ischemic Stroke was established until the clinical outcome of day 14 after stroke onset. A total of 50 subjects enrolled for this study would be examined for serum levels of vitamins A and D on admission, and on the 14th day were assessed for NIHSS as a clinical outcome.


From 50 research subjects, the mean of vitamin A and D level in the acute phase of Ischemic Stroke was 463.35 ± 116.97 µg/L and 21.65 ± 6.51 ng/mL, respectively. By using the Spearman’s correlation test, it was found that the acute phase vitamin A level and NIHSS on day 14 had a significant and strong correlation with p = 0.045 (r = -0.672). Along with it, vitamin D serum levels and NIHSS also had a significant and strong correlation with p = 0.026 (r = -0.754). Both of these results showed that vitamin A and D had an inverse association with NIHSS, meaning that the higher vitamin A and D serum levels, the better the clinical outcome would be.


Both serum vitamin A and D levels in the acute phase of Ischemic Stroke was correlated strongly with short time clinical outcome. The higher vitamin A and D serum levels in the acute phase, the better the clinical outcome would be for Ischemic Stroke patients.

Keywords: Vitamin A, Vitamin D, Ischemic Stroke, Outcome, NIHSS, Cerebrovascular disease.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 14
First Page: 6
Last Page: 9
Publisher Id: TONEUJ-14-6
DOI: 10.2174/1874205X02014010006

Article History:

Received Date: 16/12/2019
Revision Received Date: 18/04/2020
Acceptance Date: 23/04/2020
Electronic publication date: 16/06/2020
Collection year: 2020

© 2020 Kadri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Neurology Department, Faculty of Medicine, University of Sumatera Utara, No. 5, Dr. T. Mansyur Road, Medan, 20155, Indonesia; Tel: +62 61 8211045, Mobile phone: +628126010064; E-mail:

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