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Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury

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Title: Prevalence and correlates of vitamin D deficiency in adults after traumatic brain injury
Authors: Jamall, O
Feeney, C
Zaw-Linn, J
Malik, A
Niemi, M
Tenorio-Jimenez, C
Ham, TE
Jilka, SR
Jenkins, PO
Scott, G
Li, LM
Gorgoraptis, N
Baxter, D
Sharp, DJ
Goldstone, AP
Item 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.
Issue Date: 28-Mar-2016
Date of Acceptance: 23-Feb-2016
URI: http://hdl.handle.net/10044/1/29828
DOI: https://dx.doi.org/10.1111/cen.13045
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.
Sponsor/Funder: 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
Funder's Grant Number: N-2057340
COL011953
BIOSAP
N/A
NIRH-RP-011-048
MR/K023926/1
RDA03
103429/Z/13/Z
Keywords: cognition
depression
insufficiency
mood
quality of life
Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Publication Status: Published
Article Number: 4
Appears in Collections:Department of Medicine
Faculty of Medicine



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