Circulating Vitamin D Level Correlates To Microembolic Signals And Prognosis Of Patients In Large-artery Atherosclerosis Stroke

Purpose:We explored whether serum 25(OH)D correlate to MES and prognosis of patients with Large Artery Atherosclerosis(LAA)Stroke.Methods:We recruited 161 subjects,including 58 controls and 103 patients with LAA stroke(?72hours)according to the TOAST classification.The ipsilateral middle cerebral artery of all the participants were monitored for 60 min to detect MES.Serum 25(OH)D concentrations were measured by ELISA.Prognosis was assessed by the modified Rankin Scale(m RS)at 3 months after stroke.The receiver operating characteristic(ROC)curve was used to evaluate 25(OH)D as a predictor of MES and prognosis.Results:We found that serum 25(OH)D concentrations were significantly reduced in the ischemic stroke patients compared to the controls.Furthermore,The 25(OH)D levels in MES positive group were significantly lower than MES negative group.There was a significant difference in serum25(OH)D concentrations between poor prognosis group and good prognosis group.Using 25(OH)D to predict the MES-positive and MES-negative patients,the area under the ROC curve(AUC)was 0.757;the optimal cut-off value was 13.99 ng/ml.The sensitivity and specificity were 73.0% and 72.4%,respectively.Meanwhile,if we used 25(OH)D to evaluate prognosis,the ideal cut-off value of Vitamin D for prognosis was 17.97ng/ml.AUC was 0.797,The sensitivity and specificity were 64.0%and 88.7%,respectively.Conclusion:Plasma vitamin D concentrations was significantly reduced in the stroke patients than controls.Serum 25(OH)D concentrations in MES positive group was significantly lower than MES negative group.The 25(OH)D levels in poor prognosis group were significantly lower than good prognosis group.Reduced serum vitamin D concentrations may be a biomarker predicting the occurrence of microembolic signals and the prognosis of LAA stroke.