Vitamin D profile among patients with acute stroke admitted to Mulago hospital.

Abstract

Background Stroke is an important cause of adult death and disability that is on the rise in the developing world. It is preventable to an extent, through strategies aimed at controlling the risk factors. Vitamin D deficiency has recently been associated with acute stroke in the developed world. Stroke patients with vitamin D deficiency are at a greater risk of bone loss and fractures. Low vitamin D has been described in some populations in Sub-Saharan Africa in spite of adequate sunshine all year round. There is no information on the magnitude of vitamin D deficiency among patients with stroke in Sub-Saharan Africa and Uganda. Objectives To determine the prevalence and describe known factors associated with vitamin D deficiency among patients with acute stroke admitted to the medical ward in Mulago National Referral Hospital. Methods We conducted a cross sectional study conducted during 6 months from October 2012- March 2013. We consecutively recruited 142 subjects with acute stroke admitted to the medical wards of Mulago hospital. We administered a pre-tested questionnaire to the study participants, and did a detailed physical examination and laboratory evaluation to describe factors associated with vitamin D deficiency among the study subjects. Vitamin D concentration was determined using an electrochemiluminescence assay. Data were analyzed using STATA version 12 software. Results and Discussion The prevalence of vitamin D deficiency was 14.8% of the study sample. The likelihood of vitamin D deficiency significantly increased with rising age (adjusted OR 1.03, p=0.05). Longer hours of sunshine exposure decreased the likelihood vitamin D significantly (adjusted OR 0.85, p=0.03). Similarly, higher HDL cholesterol had a significant inverse association with vitamin D deficiency (adjusted OR 0.15, p=0.02). The prevalence was much lower than found in studies done in the western world. These findings do not support routine screening for vitamin D deficiency among patients with acute stroke.