BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PA...BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.展开更多
Objectives: The aim of this study was to investigate the relationship between the levels of 25-hydroxyvitamin D and the adipokine resistin in Saudi diabetic patients and those at high risk to develop atherosclerotic c...Objectives: The aim of this study was to investigate the relationship between the levels of 25-hydroxyvitamin D and the adipokine resistin in Saudi diabetic patients and those at high risk to develop atherosclerotic cardiovascular diseases. Methodology: One hundred and sixty seven subjects were recruited for the cross-sectional study at King Fahad Medical City, Saudi Arabia. Blood samples were analyzed for biochemical parameters. Serum 25-hydroxyvitamin D and resistin levels were measured for all the participants. Result: Fifty six type-1, 55 type-2 diabetic patients and 56 healthy controls were recruited. Serum 25-hydroxyvitamin D level in the control group was 44.21 ± 41.80 μg/ml compared to 50.67 ± 35.60 μg/ml in the diabetic group (P = 0.427) with no significant different between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.628). Resistin level in the control group was 14.00 ± 7.39μg/ml compared to 20.21 ± 16.94 μg/ml in the diabetic group (P ≤ 0.01), no significant difference between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.817). Resistin in those taking vitamin D supplementation was 21.34 ± 18.27 μg/ml;and in those not taking vitamin D supplementation, it was 17.4 ± 11.19 μg/ml;(P = 0.237). There was significant negative correlation between 25-hydroxyvitamin D and resistin in type-2 diabetes mellitus (P ≤ 0.043) and no significant correlation was found between vitamin 25 (OH) D and resistin level in type-1 diabetes mellitus (P = 0.538). Blood urea and creatinine showed significant positive correlation with vitamin 25 (OH) D in one hand and resistin level on the other hand. Discussion and Conclusions: Several in vitro and in vivo studies have confirmed that the vitamin 25 (OH) D have numerous important functions in the body. The circulating vitamin 25 (OH) D and resistin levels were associated with general inflammation in renal diseases. This study showed significant negative correlation between resistin level and vitamin 25 (OH) D in type 2 diabetes mellitus reflecting their roles in glucose homeostasis. The positive correlation of resistin and vitamin D with urea may reflect their involvement in kidney dysfunction. The level of serum resistin showed slight increase in diabetic patients compared to control group and it was higher in type-2 diabetes mellitus. More efforts are needed to explore the physiological mechanism of vitamin 25 (OH) D and resistin action in metabolic disorders.展开更多
Mental disorders seriously affect people’s health and social stability.This Mendelian randomization(MR)study was designed to investigate the causal relationship between circulating vitamin C(VC)or 25-hydroxyvitamin D...Mental disorders seriously affect people’s health and social stability.This Mendelian randomization(MR)study was designed to investigate the causal relationship between circulating vitamin C(VC)or 25-hydroxyvitamin D(25(OH)D)levels and mental disorders.The data used for the MR analysis were derived from the summary genome-wide association studies(GWAS)database for VC and 25(OH)D and from the Finn Gen consortium for fourteen mental disorders.Based on the inverse variance weighted(IVW)method,we found a potential causal association between circulating VC and anxiety disorders(IVW:OR=1.139,95%CI:1.023-1.269,P=0.018).However,no causal association was found between VC or 25(OH)D and other mental disorders(P>0.05).In the reverse MR analysis,individuals with Alzheimer’s disease was causally associated with higher concentrations of circulating VC(P=0.012),while individuals with anxiety disorders had a negative association between the concentrations of 25(OH)D(P=0.012).However,the current evidence does not support a causal relationship between VC or 25(OH)D and other mental disorders.In addition,there was no causal association between circulating VC and 25(OH)D(P>0.05).Future studies are needed to confirm these findings and to elucidate the mechanisms of potential causality.展开更多
BACKGROUND Vitamin deficiencies are linked to various eye diseases,and the influence of vitamin D on cataract formation has been noted in prior research.However,detailed investigations into the causal relationship bet...BACKGROUND Vitamin deficiencies are linked to various eye diseases,and the influence of vitamin D on cataract formation has been noted in prior research.However,detailed investigations into the causal relationship between 25-(OH)D status and cataract development remain scarce.AIM To explore a possible causal link between cataracts and vitamin D.METHODS In this study,we explored the causal link between 25-(OH)D levels and cataract development using Mendelian randomization.Our analytical approach included inverse-variance weighting(IVW),MR-Egger,weighted median,simple mode,and weighted mode methods.The primary analyses utilized IVW with random effects,supplemented by sensitivity and heterogeneity tests using both IVW and MR-Egger.MR-Egger was also applied for pleiotropy testing.Additionally,a leave-one-out analysis helped identify potentially impactful single-nucleotide polymorphisms.RESULTS The analysis revealed a positive association between 25-(OH)D levels and the risk of developing cataracts(OR=1.11,95%CI:1.00-1.22;P=0.032).The heterogeneity test revealed that our IVW analysis exhibited minimal heterogeneity(P>0.05),and the pleiotropy test findings confirmed the absence of pleiotropy within our IVW analysis(P>0.05).Furthermore,a search of the human genotype-phenotype association database failed to identify any potentially relevant risk-factor single nucleotide polymorphisms.CONCLUSION There is a potential causal link between 25-(OH)D levels and the development of cataracts,suggesting that greater 25-(OH)D levels may be a contributing risk factor for cataract formation.Further experimental research is required to confirm these findings.展开更多
Objective: To investigate the distribution of 25-hydroxy Vitamin D level status in type 2 diabetes mellitus inpatients, as well as the differences in general conditions and clinical indicators in patients with differe...Objective: To investigate the distribution of 25-hydroxy Vitamin D level status in type 2 diabetes mellitus inpatients, as well as the differences in general conditions and clinical indicators in patients with different Vitamin D status. Methods: Retrospective analysis of 250 admitted type 2 diabetes inpatients admitted to the endocrinology department of qinghai provincial hospital of traditional chinese medicine from september 2022 to december 2023, collated and analysed the general data and laboratory indicators of the patient cases, and applied spss26.0 to process and analyse the data and explore the differences in the general conditions and commonly used clinical nutritional indicators of type 2 diabetes in patients with different 25-hydroxyVitamin D levels. The differences between the different 25-hydroxy Vitamin D levels in type 2 diabetes mellitus patients. Results: 1) A total of 250 inpatients with type 2 diabetes mellitus were included in this study, of which 56 cases (22.4%) were patients with 25 hydroxyvitamin D deficiency [25(OH)D P P P P > 0.05). 3) The distribution of some laboratory indexes among the three groups of patients was differentiated, with the average level of glycated haemoglobin in the lack group being significantly higher than that of the remaining two groups, the average level of albumin being significantly lower than that of the remaining two groups, and the average level of haemoglobin being significantly lower than that of the good group (P P > 0.05). Conclusion: The 25(OH)D level of type 2 diabetes mellitus inpatients is not optimistic. In clinical diagnosis and treatment, we should pay attention to the changes in 25 hydroxyvitamin D levels and other nutritional indexes of patients with type 2 diabetes mellitus, and focus on the control of blood glucose levels and timely supplementation of vitamins, proteins, and lipids, in order to improve the patients’ physical status, reduce the incidence of complications, and improve the clinical efficacy and the patients’ quality of life.展开更多
Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T...Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.展开更多
To the Editor:Ischemic stroke remains a major cause of death and disability worldwide and contributes to the rising costs of health care.Thrombolytic therapy with tissue plasminogen activator (tPA,alteplase)is benefic...To the Editor:Ischemic stroke remains a major cause of death and disability worldwide and contributes to the rising costs of health care.Thrombolytic therapy with tissue plasminogen activator (tPA,alteplase)is beneficial for the treatment of acute ischemic stroke.However,only 40%to 50%of stroke patients show a significant improvement after treatment.In addition,the use of alteplase is restricted because symptomatic intracranial hemorrhase (slCH)occurs in 1.7%to 6.4%of treated patients.[1] 25-hydroxyvitamin D (25(OH)D),which is the major circulating metabolite of vitamin D,has been confirmed to be closely related to cerebrovascular disease (CVD).A series of studies indicated that vitamin D deficiency was associated with an increased risk of ischemic stroke,high stroke severity and poor functional outcomes.展开更多
We enrolled 23 Japanese men (age: 76.0 ± 8.7) and 17 women (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Blood was collected...We enrolled 23 Japanese men (age: 76.0 ± 8.7) and 17 women (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Blood was collected by venipuncture and the serum 1, 25-hydroxy vitamin D (1, 25OHD) concentration was measured. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment-Japanese version (MoCA-J) was used for the cognitive function test. Physical function was measured objectively using the Timed UP and Go (TUG) and 4-m walking test (4MWS). A significant positive correlation was found between serum 1, 25OHD and MMSE or MoCA-J. It is expected that an elderly person can maintain a mean serum 1, 25OHD level of about 100 pg/mL for preventing early cognitive disorder. In the present study, a significant positive correlation was found between urinary 25-hydroxy vitamin D (25OHD)/creatinine and MMSE or MoCA-J. Our results showed that urinary 25OHD might be a useful biomarker for predicting cognitive disorder. There was a significant negative correlation between serum 1, 25OHD and TUG or 4MWS. These findings suggest that serum 1, 25OHD levels might serve as a useful index to improve cognitive and physical functional impairment.展开更多
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.
文摘Objectives: The aim of this study was to investigate the relationship between the levels of 25-hydroxyvitamin D and the adipokine resistin in Saudi diabetic patients and those at high risk to develop atherosclerotic cardiovascular diseases. Methodology: One hundred and sixty seven subjects were recruited for the cross-sectional study at King Fahad Medical City, Saudi Arabia. Blood samples were analyzed for biochemical parameters. Serum 25-hydroxyvitamin D and resistin levels were measured for all the participants. Result: Fifty six type-1, 55 type-2 diabetic patients and 56 healthy controls were recruited. Serum 25-hydroxyvitamin D level in the control group was 44.21 ± 41.80 μg/ml compared to 50.67 ± 35.60 μg/ml in the diabetic group (P = 0.427) with no significant different between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.628). Resistin level in the control group was 14.00 ± 7.39μg/ml compared to 20.21 ± 16.94 μg/ml in the diabetic group (P ≤ 0.01), no significant difference between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.817). Resistin in those taking vitamin D supplementation was 21.34 ± 18.27 μg/ml;and in those not taking vitamin D supplementation, it was 17.4 ± 11.19 μg/ml;(P = 0.237). There was significant negative correlation between 25-hydroxyvitamin D and resistin in type-2 diabetes mellitus (P ≤ 0.043) and no significant correlation was found between vitamin 25 (OH) D and resistin level in type-1 diabetes mellitus (P = 0.538). Blood urea and creatinine showed significant positive correlation with vitamin 25 (OH) D in one hand and resistin level on the other hand. Discussion and Conclusions: Several in vitro and in vivo studies have confirmed that the vitamin 25 (OH) D have numerous important functions in the body. The circulating vitamin 25 (OH) D and resistin levels were associated with general inflammation in renal diseases. This study showed significant negative correlation between resistin level and vitamin 25 (OH) D in type 2 diabetes mellitus reflecting their roles in glucose homeostasis. The positive correlation of resistin and vitamin D with urea may reflect their involvement in kidney dysfunction. The level of serum resistin showed slight increase in diabetic patients compared to control group and it was higher in type-2 diabetes mellitus. More efforts are needed to explore the physiological mechanism of vitamin 25 (OH) D and resistin action in metabolic disorders.
基金funded by the Nactional Natural Science Foundation of China(81872618)。
文摘Mental disorders seriously affect people’s health and social stability.This Mendelian randomization(MR)study was designed to investigate the causal relationship between circulating vitamin C(VC)or 25-hydroxyvitamin D(25(OH)D)levels and mental disorders.The data used for the MR analysis were derived from the summary genome-wide association studies(GWAS)database for VC and 25(OH)D and from the Finn Gen consortium for fourteen mental disorders.Based on the inverse variance weighted(IVW)method,we found a potential causal association between circulating VC and anxiety disorders(IVW:OR=1.139,95%CI:1.023-1.269,P=0.018).However,no causal association was found between VC or 25(OH)D and other mental disorders(P>0.05).In the reverse MR analysis,individuals with Alzheimer’s disease was causally associated with higher concentrations of circulating VC(P=0.012),while individuals with anxiety disorders had a negative association between the concentrations of 25(OH)D(P=0.012).However,the current evidence does not support a causal relationship between VC or 25(OH)D and other mental disorders.In addition,there was no causal association between circulating VC and 25(OH)D(P>0.05).Future studies are needed to confirm these findings and to elucidate the mechanisms of potential causality.
文摘BACKGROUND Vitamin deficiencies are linked to various eye diseases,and the influence of vitamin D on cataract formation has been noted in prior research.However,detailed investigations into the causal relationship between 25-(OH)D status and cataract development remain scarce.AIM To explore a possible causal link between cataracts and vitamin D.METHODS In this study,we explored the causal link between 25-(OH)D levels and cataract development using Mendelian randomization.Our analytical approach included inverse-variance weighting(IVW),MR-Egger,weighted median,simple mode,and weighted mode methods.The primary analyses utilized IVW with random effects,supplemented by sensitivity and heterogeneity tests using both IVW and MR-Egger.MR-Egger was also applied for pleiotropy testing.Additionally,a leave-one-out analysis helped identify potentially impactful single-nucleotide polymorphisms.RESULTS The analysis revealed a positive association between 25-(OH)D levels and the risk of developing cataracts(OR=1.11,95%CI:1.00-1.22;P=0.032).The heterogeneity test revealed that our IVW analysis exhibited minimal heterogeneity(P>0.05),and the pleiotropy test findings confirmed the absence of pleiotropy within our IVW analysis(P>0.05).Furthermore,a search of the human genotype-phenotype association database failed to identify any potentially relevant risk-factor single nucleotide polymorphisms.CONCLUSION There is a potential causal link between 25-(OH)D levels and the development of cataracts,suggesting that greater 25-(OH)D levels may be a contributing risk factor for cataract formation.Further experimental research is required to confirm these findings.
文摘Objective: To investigate the distribution of 25-hydroxy Vitamin D level status in type 2 diabetes mellitus inpatients, as well as the differences in general conditions and clinical indicators in patients with different Vitamin D status. Methods: Retrospective analysis of 250 admitted type 2 diabetes inpatients admitted to the endocrinology department of qinghai provincial hospital of traditional chinese medicine from september 2022 to december 2023, collated and analysed the general data and laboratory indicators of the patient cases, and applied spss26.0 to process and analyse the data and explore the differences in the general conditions and commonly used clinical nutritional indicators of type 2 diabetes in patients with different 25-hydroxyVitamin D levels. The differences between the different 25-hydroxy Vitamin D levels in type 2 diabetes mellitus patients. Results: 1) A total of 250 inpatients with type 2 diabetes mellitus were included in this study, of which 56 cases (22.4%) were patients with 25 hydroxyvitamin D deficiency [25(OH)D P P P P > 0.05). 3) The distribution of some laboratory indexes among the three groups of patients was differentiated, with the average level of glycated haemoglobin in the lack group being significantly higher than that of the remaining two groups, the average level of albumin being significantly lower than that of the remaining two groups, and the average level of haemoglobin being significantly lower than that of the good group (P P > 0.05). Conclusion: The 25(OH)D level of type 2 diabetes mellitus inpatients is not optimistic. In clinical diagnosis and treatment, we should pay attention to the changes in 25 hydroxyvitamin D levels and other nutritional indexes of patients with type 2 diabetes mellitus, and focus on the control of blood glucose levels and timely supplementation of vitamins, proteins, and lipids, in order to improve the patients’ physical status, reduce the incidence of complications, and improve the clinical efficacy and the patients’ quality of life.
基金supported by the National Natural Science Foundation of China(No.82120108008,No.91857117)the Project of Biobank(No.YBKA201909)from Shanghai Ninth People’s Hospital,Shanghai Jiaotong University School of Medicinea grant from Shanghai Jiaotong University School of Medicine(No.19XJ11007).
文摘Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.
文摘To the Editor:Ischemic stroke remains a major cause of death and disability worldwide and contributes to the rising costs of health care.Thrombolytic therapy with tissue plasminogen activator (tPA,alteplase)is beneficial for the treatment of acute ischemic stroke.However,only 40%to 50%of stroke patients show a significant improvement after treatment.In addition,the use of alteplase is restricted because symptomatic intracranial hemorrhase (slCH)occurs in 1.7%to 6.4%of treated patients.[1] 25-hydroxyvitamin D (25(OH)D),which is the major circulating metabolite of vitamin D,has been confirmed to be closely related to cerebrovascular disease (CVD).A series of studies indicated that vitamin D deficiency was associated with an increased risk of ischemic stroke,high stroke severity and poor functional outcomes.
文摘We enrolled 23 Japanese men (age: 76.0 ± 8.7) and 17 women (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Blood was collected by venipuncture and the serum 1, 25-hydroxy vitamin D (1, 25OHD) concentration was measured. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment-Japanese version (MoCA-J) was used for the cognitive function test. Physical function was measured objectively using the Timed UP and Go (TUG) and 4-m walking test (4MWS). A significant positive correlation was found between serum 1, 25OHD and MMSE or MoCA-J. It is expected that an elderly person can maintain a mean serum 1, 25OHD level of about 100 pg/mL for preventing early cognitive disorder. In the present study, a significant positive correlation was found between urinary 25-hydroxy vitamin D (25OHD)/creatinine and MMSE or MoCA-J. Our results showed that urinary 25OHD might be a useful biomarker for predicting cognitive disorder. There was a significant negative correlation between serum 1, 25OHD and TUG or 4MWS. These findings suggest that serum 1, 25OHD levels might serve as a useful index to improve cognitive and physical functional impairment.
