RESUMO
BACKGROUND & AIMS: A growing number of studies have shown that vitamin D are related to the risk of stroke, however, the dose-response association between vitamin D and the risk of stroke is still unclear. Accordingly, we conducted a dose-response meta-analysis to evaluate the relationships between 25-hydroxyvitamin D [25(OH)D] level, vitamin D intake, and the risk of stroke by summarizing cohort studies. METHODS: PubMed, Embase, Cochrane and the Web of Science database were searched for related studies. Cohort studies examining the influence of 25(OH)D level and vitamin D intake on stroke risk were summarized. Dose-response relationships were determined using a random-effect model. RESULTS: Twenty cohort studies involving 217,235 participants were included. The pooled relative risk for the high-versus-low categories was 0.74 (95% CI: 0.66-0.83) for 25(OH)D level, and 0.75 (95% CI: 0.57-0.98) for vitamin D intake. In addition, there were non-linear relationships between 25(OH)D level, vitamin D intake, and stroke risk. The incidence of stroke was reduced to its lowest point, with a reduction of about 20%, when 25(OH)D level was about 50 nmol/L or vitamin D intake was about 12 µg/day. CONCLUSION: 25(OH)D level and vitamin D intake were both inversely related to stroke risk, with a non-linear dose-response relationship.
Assuntos
Suplementos Nutricionais , Acidente Vascular Cerebral/prevenção & controle , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/análogos & derivados , Vitamina D/uso terapêutico , Adulto , Idoso , Biomarcadores/sangue , Suplementos Nutricionais/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento , Vitamina D/efeitos adversos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologiaRESUMO
Wernicke's encephalopathy (WE) is acute metabolic disease of the central nervous system caused by deficiency of thiamine. Typical imaging findings are bilateral and symmetric signal in mammillary bodies, medial thalamus and periaqueductal gray. We present a 45-year-old man diagnosed for WE with two seizures and unconsciousness. The magnetic resonance imaging showed bilateral and symmetrical signal hyper-intensities in the frontal and parietal cortex, in addition to the classical MRI findings of WE. Cortical damage in WE is rare. The patient was improved significantly from unconsciousness to obeying commands and answering questions after 3days by thiamine supplementation. But the muscle strength and conscious state did not improve after 1year. This case report reminds us that we should take into account the possibility of WE when imaging shows cortical damage.