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Clin Endocrinol (Oxf). 2016 Oct;85(4):636-44. doi: 10.1111/cen.13045. Epub 2016 Mar 28.

Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury.

Author information

1
Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK.
2
Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK.
3
Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK. tony.goldstone@imperial.ac.uk.
4
Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK. tony.goldstone@imperial.ac.uk.
5
Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK. tony.goldstone@imperial.ac.uk.

Abstract

OBJECTIVES:

Traumatic brain injury (TBI) is a major cause of long-term disability with variable recovery. Preclinical studies suggest that vitamin D status influences the recovery after TBI. However, there is no published clinical data on links between vitamin D status and TBI outcomes. The aim was to determine the (i) prevalence of vitamin D deficiency/insufficiency, and associations of vitamin D status with (ii) demographic factors and TBI severity, and with (iii) cognitive function, symptoms and quality of life, in adults after TBI.

DESIGN:

Retrospective audit of patients seen between July 2009 and March 2015. Serum vitamin D (25-hydroxy-cholecalciferol) was categorized as deficient (<40 nmol/l), insufficient (40-70 nmol/l) or replete (>70 nmol/l).

PATIENTS:

A total of 353 adults seen in tertiary hospital clinic (75·4% lighter skinned, 74·8% male, age median 35·1 year, range 26·6-48·3 year), 0·3-56·5 months after TBI (74·5% moderate-severe).

MEASUREMENTS:

Serum vitamin D concentrations; Addenbrooke's Cognitive Examination (ACE-R), Beck Depression Inventory-II (BDI-II), SF-36 Quality of Life, Pittsburgh Sleep Quality Index.

RESULTS:

In total, 46·5% of patients after TBI had vitamin D deficiency and 80·2% insufficiency/deficiency. Patients with vitamin D deficiency had lower ACE-R scores than those of vitamin D replete (mean effect size ± SEM 4·5 ± 2·1, P = 0·034), and higher BDI-II scores than those of vitamin D insufficient (4·5 ± 1·6, P = 0·003), correcting for age, gender, time since TBI and TBI severity. There was no association between vitamin D status and markers of TBI severity, sleep or quality of life.

CONCLUSION:

Vitamin D deficiency is common in patients after TBI and associated with impaired cognitive function and more severe depressive symptoms.

PMID:
26921561
PMCID:
PMC5053278
DOI:
10.1111/cen.13045
[Indexed for MEDLINE]
Free PMC Article

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