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Open Access 01-12-2024 | Research

Genetic association between serum 25-hydroxyvitamin D levels and functional outcome after ischemic stroke

Authors: Yudan Wu, Tianyu Jin, Qiongyi Pang, Yifan Cheng

Published in: BMC Neurology | Issue 1/2024

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Abstract

Background

Previous observational studies suggest that serum 25-hydroxyvitamin D [25(OH)D] levels may associate with functional outcome after ischemic stroke. However, the causal relationship is not yet defined. Consequently, this study employed two-sample Mendelian Randomization (MR) to elucidate the causal association between serum 25(OH)D levels and functional outcome after ischemic stroke.

Methods

The genome-wide association study (GWAS) for serum 25(OH)D levels included 417,580 patients of European descent. The GWAS for functional outcome after ischemic stroke is from Genetics of Ischemic Stroke Functional Outcome meta-analysis. Post-stroke outcomes were evaluated using two sets of binary categorical variables (0–2 vs. 3–6 and 0–1 vs. 2–6), and also as ordered modified Rankin Scale (mRS) variables at 3 months. Two-sample MR was used to assess whether the exposure causally affects the outcome. Inverse Variance Weighted (IVW) was the primary method for our MR analysis, which was further supported by sensitivity analyses to ensure the robustness of the results.

Results

The primary analysis using IVW method indicated no significant casual association between serum 25(OH)D levels and mRS (0–1) vs. mRS (2–6) at 3 months (OR = 0.914, 95% CI: 0.587–1.422, P = 0.69), mRS (0–2) vs. mRS (3–6) at 3 months (OR = 0.699, 95% CI: 0.477–1.025, P = 0.07), and mRS at 3 months (OR = 1.202, 95% CI: 0.875–1.650, P = 0.26). Additionally, after adjusting for stroke severity, the IVW analysis also showed no significant association between serum 25(OH)D levels and mRS (0–1) vs. mRS (2–6) at 3 months (OR = 0.93, 95% CI: 0.55–1.56, P = 0.78), mRS (0–2) vs. mRS (3–6) at 3 months (OR = 0.73, 95% CI: 0.47–1.13, P = 0.16), and mRS at 3 months (OR = 1.09, 95% CI: 0.77–1.54, P = 0.62). The results of the sensitivity analysis suggest that our findings are robust.

Conclusion

Our MR study offers no genetic evidence supporting the effects of serum 25(OH)D levels on functional outcomes after ischemic stroke. The associations observed in previous observational studies may be attributed to residual confounding factors and reverse causality.
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Literature
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go back to reference van der Willik EM, van Zwet EW, Hoekstra T, van Ittersum FJ, Hemmelder MH, Zoccali C, et al. Funnel plots of patient-reported outcomes to evaluate health-care quality: basic principles, pitfalls and considerations. Nephrol (Carlton Vic). 2021;26 2:95–104. https://doi.org/10.1111/nep.13761.CrossRef van der Willik EM, van Zwet EW, Hoekstra T, van Ittersum FJ, Hemmelder MH, Zoccali C, et al. Funnel plots of patient-reported outcomes to evaluate health-care quality: basic principles, pitfalls and considerations. Nephrol (Carlton Vic). 2021;26 2:95–104. https://​doi.​org/​10.​1111/​nep.​13761.CrossRef
Metadata
Title
Genetic association between serum 25-hydroxyvitamin D levels and functional outcome after ischemic stroke
Authors
Yudan Wu
Tianyu Jin
Qiongyi Pang
Yifan Cheng
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-024-03972-x