Pil-Wook Chung1, Kwang-Yeol Park2, Jeong-Min Kim1, Dong-Woo Shin1, Moo-Seok Park1, Yun Jae Chung1, Sam-Yeol Ha1, Suk-Won Ahn1, Hae-Won Shin1, Yong Bum Kim1, Heui-Soo Moon1. 1. From the Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (P.-W.C., Y.B.K., H.-S.M.); Department of Neurology (K.-Y.P., J.-M.K., D.-W.S., M.-S.P., S.-W.A., H.-W.S.) and Division of Endocrinology, Department of Internal Medicine (Y.J.C.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea; and Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea (S.-Y.H.). 2. From the Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (P.-W.C., Y.B.K., H.-S.M.); Department of Neurology (K.-Y.P., J.-M.K., D.-W.S., M.-S.P., S.-W.A., H.-W.S.) and Division of Endocrinology, Department of Internal Medicine (Y.J.C.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea; and Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea (S.-Y.H.). kwangyeol.park@gmail.com.
Abstract
BACKGROUND AND PURPOSE: The aim of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) and neuroimaging correlates of cerebral small vessel disease. METHODS: We identified 759 consecutive patients with acute ischemic stroke or transient ischemic attack. Lacunes, white matter hyperintensity, and cerebral microbleed (CMB) were assessed using MR images. Deep CMB was defined as the presence of CMB in basal ganglia, thalamus, or brain stem. The association between 25(OH)D and small vessel disease was tested using linear and logistic regression analyses. RESULTS: Mean age was 68 (±13) years. Mean level of 25(OH)D was 34.1±17.8 nmol/L. On bivariate analysis, a 25-nmol/L decrease in 25(OH)D was associated with lacunes (regression coefficient, 0.23; 95% confidence interval [CI], 0.02-0.45), severe white matter hyperintensity (odds ratio, 2.05; 95% CI, 1.41-3.08), and deep CMB (odds ratio, 1.28; 95% CI, 1.01-1.63). Also, 25(OH)D deficiency (≤25 nmol/L) was associated with lacunes (regression coefficient, 0.5; 95% CI, 0.04-0.95), severe white matter hyperintensity (odds ratio, 2.74; 95% CI, 1.31-6.45), and deep CMB (odds ratio, 1.68; 95% CI, 1.03-2.78). The association remained significant even after multivariable adjustment and in the subgroup of previously healthy patients. CONCLUSIONS: 25(OH)D is inversely associated with lacunes, white matter hyperintensity, and deep CMB. Our findings suggest that 25(OH)D is linked to small vessel disease, and in future trials it should be tested whether 25(OH)D supplementation can prevent small vessel disease.
BACKGROUND AND PURPOSE: The aim of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) and neuroimaging correlates of cerebral small vessel disease. METHODS: We identified 759 consecutive patients with acute ischemic stroke or transient ischemic attack. Lacunes, white matter hyperintensity, and cerebral microbleed (CMB) were assessed using MR images. Deep CMB was defined as the presence of CMB in basal ganglia, thalamus, or brain stem. The association between 25(OH)D and small vessel disease was tested using linear and logistic regression analyses. RESULTS: Mean age was 68 (±13) years. Mean level of 25(OH)D was 34.1±17.8 nmol/L. On bivariate analysis, a 25-nmol/L decrease in 25(OH)D was associated with lacunes (regression coefficient, 0.23; 95% confidence interval [CI], 0.02-0.45), severe white matter hyperintensity (odds ratio, 2.05; 95% CI, 1.41-3.08), and deep CMB (odds ratio, 1.28; 95% CI, 1.01-1.63). Also, 25(OH)D deficiency (≤25 nmol/L) was associated with lacunes (regression coefficient, 0.5; 95% CI, 0.04-0.95), severe white matter hyperintensity (odds ratio, 2.74; 95% CI, 1.31-6.45), and deep CMB (odds ratio, 1.68; 95% CI, 1.03-2.78). The association remained significant even after multivariable adjustment and in the subgroup of previously healthy patients. CONCLUSIONS:25(OH)D is inversely associated with lacunes, white matter hyperintensity, and deep CMB. Our findings suggest that 25(OH)D is linked to small vessel disease, and in future trials it should be tested whether 25(OH)D supplementation can prevent small vessel disease.
Authors: Megan A Evans; Hyun Ah Kim; T Michael De Silva; Thiruma V Arumugam; Andrew N Clarkson; Grant R Drummond; Graeme R Zosky; Brad Rs Broughton; Christopher G Sobey Journal: J Cereb Blood Flow Metab Date: 2017-08-23 Impact factor: 6.200
Authors: Thomas J Littlejohns; Katarina Kos; William E Henley; Iain A Lang; Cedric Annweiler; Olivier Beauchet; Paulo H M Chaves; Bryan R Kestenbaum; Lewis H Kuller; Kenneth M Langa; Oscar L Lopez; David J Llewellyn Journal: PLoS One Date: 2016-05-11 Impact factor: 3.240
Authors: Unal Mutlu; M Arfan Ikram; Albert Hofman; Paulus T V M de Jong; Andre G Uitterlinden; Caroline C W Klaver; M Kamran Ikram Journal: Medicine (Baltimore) Date: 2016-12 Impact factor: 1.817