Objective: Aneurysmal subarachnoid hemorrhage management is hampered by our incomplete understanding of what variables promote aneurysm formation, growth, and rupture. Because hypovitaminosis D has been identified as a risk factor for other vascular diseases, we examined its association with cerebral aneurysms requiring treatment.
Methods: We retrospectively reviewed charts of patients with cerebral aneurysms with recorded 25-hydroxy vitamin D levels undergoing treatment at our institution from May 2010 to May 2015. We compared these patients with a group of patients without aneurysms. We used multivariable Poisson regression and backward elimination to identify factors associated with cerebral aneurysms, with a threshold P < 0.20. A propensity-matching algorithm was used, incorporating all factors with P < 0.10 in our regression model.
Results: Patients in the aneurysm group were older than those in the control group (P = 0.001) and more likely to be female (P = 0.004), to be tobacco users (P < 0.001), and to have a diagnosis of hypertension (P = 0.001), but ethnicity, body mass index, and diabetes rates did not differ. Vitamin D levels in the aneurysm group were lower than in the control group (23.3 ± 12.3 vs. 28.7 ± 14.1 ng/mL, P = 0.001), and the patients were more likely to be vitamin D deficient (P = 0.028). Multivariable Poisson regression demonstrated that vitamin D level, tobacco use, age, and sex were significantly associated with aneurysms requiring treatment (P < 0.05). The propensity-matching algorithm confirmed a significant difference in vitamin D levels between the aneurysm and control groups (P = 0.01).
Conclusions: Patients with cerebral aneurysms requiring treatment have a significantly higher incidence of hypovitaminosis D compared with patients in a control group.
Keywords: Aneurysm; Propensity matching; Subarachnoid hemorrhage; Vitamin D.
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