Volume 22, Issue 9 pp. 1269-1274

Original Article

Low serum levels of vitamin D are associated with post-stroke depression

B. Han,

B. Han

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

Y. Lyu,

Y. Lyu

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

H. Sun,

H. Sun

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

Y. Wei,

Y. Wei

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

J. He,

Corresponding Author

J. He

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Correspondence: J. He, Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China (tel./fax: +86 0577 55579363;

e-mail: [email protected]).

Search for more papers by this author

B. Han,

B. Han

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

Y. Lyu,

Y. Lyu

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

H. Sun,

H. Sun

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

Y. Wei,

Y. Wei

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for more papers by this author

J. He,

Corresponding Author

J. He

Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Correspondence: J. He, Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China (tel./fax: +86 0577 55579363;

e-mail: [email protected]).

Search for more papers by this author

First published: 02 December 2014

https://doi.org/10.1111/ene.12607

Citations: 42

See editorial by Béjot on page 1247.

Share a link

Email
Wechat
Bluesky

Abstract

Background and purpose

Low serum levels of vitamin D have been associated with depression in non-stroke subjects. Our aim was to examine the possible association between serum vitamin D levels and the development of post-stroke depression (PSD).

Methods

In total, 189 patients with acute ischaemic stroke were consecutively recruited. Serum levels of 25-hydroxyvitamin D [25(OH)D] were measured by competitive protein-binding assay within 24 h after admission. The 17-item Hamilton Depression Scale was used for screening for the existence of depressive symptoms at 1 month after stroke. Patients with a Hamilton Depression Scale score of ≥7 were given the Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, for diagnosis of PSD. Meanwhile, 100 healthy control subjects were also recruited and underwent measurement of 25(OH)D.

Results

Fifty-five patients (29.1%) were diagnosed as having PSD at 1 month. Serum vitamin D levels within 24 h after admission were significantly lower in both non-PSD patients and PSD patients than in normal controls. PSD patients had significantly lower vitamin D than non-PSD patients. Serum vitamin D levels (≤37.1 and ≥64.1 nmol/l) were independently associated with the development of PSD (odds ratio 8.824, 95% confidence interval 2.011–38.720, P = 0.004, and odds ratio 0.127, 95% confidence interval 0.022–0.718, P = 0.020, respectively).

Conclusions

Serum vitamin D levels within 24 h after admission are found to be associated with PSD and may predict its development at 1 month post-stroke.

References

1White CL, McClure LA, Wallace PM, et al. The correlates and course of depression in patients with lacunar stroke: results from the Secondary Prevention of Small Subcortical Strokes (SPS3) study. Cerebrovasc Dis 2011; 32: 354–360.
10.1159/000330350
PubMed Web of Science® Google Scholar
2Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke 2005; 36: 1330–1340.
10.1161/01.STR.0000165928.19135.35
PubMed Web of Science® Google Scholar
3Ayerbe L, Ayis S, Crichton S, Wolfe CD, Rudd AG. The natural history of depression up to 15 years after stroke: the South London Stroke Register. Stroke 2013; 44: 1105–1110.
10.1161/STROKEAHA.111.679340
PubMed Web of Science® Google Scholar
4Ayerbe L, Ayis S, Wolfe CD, Rudd AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry 2013; 202: 14–21.
10.1192/bjp.bp.111.107664
PubMed Web of Science® Google Scholar
5Schmid AA, Kroenke K, Hendrie HC, Bakas T, Sutherland JM, Williams LS. Poststroke depression and treatment effects on functional outcomes. Neurology 2011; 76: 1000–1005.
10.1212/WNL.0b013e318210435e
CAS PubMed Web of Science® Google Scholar
6Linden T, Blomstrand C, Skoog I. Depressive disorders after 20 months in elderly stroke patients: a case−control study. Stroke 2007; 38: 1860–1863.
10.1161/STROKEAHA.106.471805
PubMed Web of Science® Google Scholar
7Yuan HW, Wang CX, Zhang N, et al. Poststroke depression and risk of recurrent stroke at 1 year in a Chinese cohort study. PLoS One 2012; 7: e46906.
10.1371/journal.pone.0046906
CAS PubMed Web of Science® Google Scholar
8Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: Relevance for autism. FASEB J 2014; 28: 2398–2413.
10.1096/fj.13-246546
CAS PubMed Web of Science® Google Scholar
9Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 2005; 29: 21–30.
10.1016/j.jchemneu.2004.08.006
CAS PubMed Web of Science® Google Scholar
10Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 2008; 65: 508–512.
10.1001/archpsyc.65.5.508
CAS PubMed Web of Science® Google Scholar
11May HT, Bair TL, Lappe DL, et al. Association of vitamin D levels with incident depression among a general cardiovascular population. Am Heart J 2010; 159: 1037–1043.
10.1016/j.ahj.2010.03.017
CAS PubMed Web of Science® Google Scholar
12Lapid MI, Cha SS, Takahashi PY. Vitamin D and depression in geriatric primary care patients. Clin Interv Aging 2013; 8: 509–514.
10.2147/CIA.S42838
CAS PubMed Web of Science® Google Scholar
13Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med 2008; 264: 599–609.
10.1111/j.1365-2796.2008.02008.x
CAS PubMed Web of Science® Google Scholar
14Shaffer JA, Edmondson D, Wasson LT, et al. Vitamin D supplementation for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials. Psychosom Med 2014; 76: 190–196.
10.1097/PSY.0000000000000044
CAS PubMed Web of Science® Google Scholar
15Li G, Mbuagbaw L, Samaan Z, et al. Efficacy of vitamin D supplementation in depression in adults: a systematic review. J Clin Endocrinol Metab 2014; 99: 757–767.
10.1210/jc.2013-3450
CAS PubMed Web of Science® Google Scholar
16Poole KE, Loveridge N, Barker PJ, et al. Reduced vitamin D in acute stroke. Stroke 2006; 37: 243–245.
10.1161/01.STR.0000195184.24297.c1
CAS PubMed Web of Science® Google Scholar
17McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med 2011; 155: 820–826.
10.7326/0003-4819-155-12-201112200-00004
PubMed Web of Science® Google Scholar
18Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.
10.1111/j.2044-8341.1959.tb00467.x
CAS PubMed Web of Science® Google Scholar
19Xie GR, Shen QJ. Use of the Chinese version of the Hamilton Rating Scale for depression in general population and patients with major depression. Chin J Nerv Ment Dis 1984; 10: 346.
Google Scholar
20De Silva DA, Talabucon LP, Ng EY, Ang ES, Tan EK, Lee WL. Vitamin D deficiency and its relation to underlying stroke etiology in ethnic Asian ischemic stroke patients. Int J Stroke 2013; 8: E18.
10.1111/j.1747-4949.2012.00958.x
CAS PubMed Web of Science® Google Scholar
21Zhang WN, Pan YH, Wang XY, Zhao Y. A prospective study of the incidence and correlated factors of post-stroke depression in China. PLoS One 2013; 8: e78981.
10.1371/journal.pone.0078981
PubMed Web of Science® Google Scholar
22Berg A, Palomaki H, Lehtihalmes M, Lonnqvist J, Kaste M. Poststroke depression: an 18-month follow-up. Stroke 2003; 34: 138–143.
10.1161/01.STR.0000048149.84268.07
Google Scholar
23Poynter B, Shuman M, Diaz-Granados N, Kapral M, Grace SL, Stewart DE. Sex differences in the prevalence of post-stroke depression: a systematic review. Psychosomatics 2009; 50: 563–569.
10.1016/S0033-3182(09)70857-6
PubMed Web of Science® Google Scholar
24Carson AJ, MacHale S, Allen K, et al. Depression after stroke and lesion location: a systematic review. Lancet 2000; 356: 122–126.
10.1016/S0140-6736(00)02448-X
CAS PubMed Web of Science® Google Scholar
25Hackett ML, Anderson CS. Predictors of depression after stroke: a systematic review of observational studies. Stroke 2005; 36: 2296–2301.
10.1161/01.STR.0000183622.75135.a4
CAS PubMed Web of Science® Google Scholar
26Milaneschi Y, Hoogendijk W, Lips P, et al. The association between low vitamin D and depressive disorders. Mol Psychiatry 2014; 19: 444–451.
10.1038/mp.2013.36
CAS PubMed Web of Science® Google Scholar
27Robinson M, Whitehouse AJ, Newnham JP, et al. Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Arch Womens Ment Health 2014; 17: 213–219.
10.1007/s00737-014-0422-y
PubMed Web of Science® Google Scholar
28Kano O, Iwamoto K, Cridebring D, Ikeda K, Iwasaki Y. Relationship between vitamin D and depression in multiple sclerosis. Acta Neurol Scand 2012; 125: e25.
10.1111/j.1600-0404.2011.01641.x
CAS PubMed Web of Science® Google Scholar
29Ganji V, Milone C, Cody MM, McCarty F, Wang YT. Serum vitamin D concentrations are related to depression in young adult US population: the Third National Health and Nutrition Examination Survey. Int Arch Med 2010; 3: 29.
10.1186/1755-7682-3-29
CAS PubMed Google Scholar
30Buell JS, Dawson-Hughes B. Vitamin D and neurocognitive dysfunction: preventing ʻDʼecline? Mol Aspects Med 2008; 29: 415–422.
10.1016/j.mam.2008.05.001
CAS PubMed Web of Science® Google Scholar
31Song C, Wang H. Cytokines mediated inflammation and decreased neurogenesis in animal models of depression. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35: 760–768.
10.1016/j.pnpbp.2010.06.020
CAS PubMed Web of Science® Google Scholar
32Zittermann A, Dembinski J, Stehle P. Low vitamin D status is associated with low cord blood levels of the immunosuppressive cytokine interleukin-10. Pediatr Allergy Immunol 2004; 15: 242–246.
10.1111/j.1399-3038.2004.00140.x
CAS PubMed Web of Science® Google Scholar
33Jin R, Yang G, Li G. Inflammatory mechanisms in ischemic stroke: role of inflammatory cells. J Leukoc Biol 2010; 87: 779–789.
10.1189/jlb.1109766
CAS PubMed Web of Science® Google Scholar
34Mora JR, Iwata M, von Andrian UH. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 2008; 8: 685–698.
10.1038/nri2378
CAS PubMed Web of Science® Google Scholar
35van Etten E, Stoffels K, Gysemans C, Mathieu C, Overbergh L. Regulation of vitamin D homeostasis: implications for the immune system. Nutr Rev 2008; 66: S125–S134.
10.1111/j.1753-4887.2008.00096.x
PubMed Web of Science® Google Scholar

Citing Literature

Volume22, Issue9

September 2015

Pages 1269-1274

Low serum levels of vitamin D are associated with post-stroke depression

Abstract

Background and purpose

Methods

Results

Conclusions

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Low serum levels of vitamin D are associated with post-stroke depression

Abstract

Background and purpose

Methods

Results

Conclusions

References

Citing Literature

References

Related

Information