The Role of Calcitriol (Vitamin D) as Neuroprotection and Prognostic Biomarker in Patients With Ischemic and Hemorrhagic Stroke

Abstract

Background: Stroke is a leading cause of long-term neurological disability, significantly impacting global morbidity and mortality. Vitamin D supplementation shows neuroprotective potential, yet research on its effects and role as a prognostic biomarker in stroke patients remains limited.

Methods: This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched Google Scholar, PubMed, and Scopus for studies assessing vitamin D’s neuroprotective effects, measured by standardized mean difference (SMD) with a 95% confidence interval (CI). We also evaluated vitamin D levels as a biomarker for stroke prognosis using odds ratio (OR) with a 95% CI. Out of 3,171 identified articles, 23 relevant studies involving 4,911 patients with ischemic and hemorrhagic strokes were included.

Results: The analysis indicated that vitamin D supplementation significantly improved neurological function (SMD, 0.63; 95% CI, 0.31–0.95; P = 0.0001) for both high-dose intramuscular injections and low-dose oral supplementation given daily or weekly. Additionally, low vitamin D levels were associated with stroke severity (OR, 3.44; 95% CI, 1.84–6.44; P < 0.0001), suggesting that vitamin D levels have potential as a prognostic biomarker.

Conclusion: These findings underscore the importance of vitamin D as an additional therapeutic strategy in stroke management. Despite the heterogeneity in the analysis, the results support the need for further research to determine the optimal dosage and to understand the effects of comorbidities. Additionally, the development of evidence-based clinical practice guidelines is necessary for the implementation of vitamin D administration in stroke rehabilitation.