Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury
File(s)
Author(s)
Type
Journal Article
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 recovery after TBI. However, there is no published
clinical data on links between vitamin D status and TBI outcomes. 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 categorised as deficient (<40nmol/L), insufficient (40-70nmol/L) or replete
(>70nmol/L).
Patients: 353 adults seen in tertiary hospital clinic (75.4% lighter-skinned, 74.8% male, age median 35.1y,
range 26.6-48.3y), 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: 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 vitamin D replete (mean effect size ± SEM 4.5
± 2.1, P=0.034), and higher BDI-II scores than those vitamin D insufficient (4.5 ± 1.6, P=0.003), correcting for
age, gender, time since TBI, 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.
studies suggest that vitamin D status influences recovery after TBI. However, there is no published
clinical data on links between vitamin D status and TBI outcomes. 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 categorised as deficient (<40nmol/L), insufficient (40-70nmol/L) or replete
(>70nmol/L).
Patients: 353 adults seen in tertiary hospital clinic (75.4% lighter-skinned, 74.8% male, age median 35.1y,
range 26.6-48.3y), 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: 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 vitamin D replete (mean effect size ± SEM 4.5
± 2.1, P=0.034), and higher BDI-II scores than those vitamin D insufficient (4.5 ± 1.6, P=0.003), correcting for
age, gender, time since TBI, 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.
Date Issued
2016-03-28
Date Acceptance
2016-02-23
Citation
Clinical Endocrinology, 2016, 85, pp.636-644
ISSN
1365-2265
Publisher
Wiley
Start Page
636
End Page
644
Journal / Book Title
Clinical Endocrinology
Volume
85
Copyright Statement
© 2016 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. 1
This is an open access article under the terms of the Creative Commons Attribution License,
which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License,
which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Pfizer Limited
GlaxoSmithKline Services Unlimited
Ministry Of Defence
Guarantors of Brain
National Institute for Health Research
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
Wellcome Trust
Grant Number
N-2057340
COL011953
BIOSAP
N/A
NIRH-RP-011-048
MR/K023926/1
RDA03
103429/Z/13/Z
Subjects
cognition
depression
insufficiency
mood
quality of life
Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Publication Status
Published
Article Number
4