RESEARCH ARTICLE


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



Alfansuri Kadri1, *
iD
, 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


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Creative Commons License
© 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: (https://creativecommons.org/licenses/by/4.0/legalcode). 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: alfansurikadri@yahoo.com


Abstract

Background:

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.

Objective:

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).

Methods:

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.

Results:

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.

Conclusion:

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.