Research Reports - Prevalence and correlates of Vitamin D deficiency in adults after traumatic brain injury

Clin Endocrinol (Oxf). 2016 Feb 27. doi: 10.1111/cen.13045. [Epub ahead of print]

Jamall OA(1), Feeney C(1,)(2), Zaw-Linn J(1), Malik A(1), Niemi ME(1),
Tenorio-Jimenez C(1,)(2), Ham TE(1), Jilka SR(1), Jenkins PO(1), Scott G(1), Li
LM(1), Gorgoraptis N(1), Baxter D(1), Sharp DJ(1), Goldstone AP(1,)(2,)(3).

OBJECTIVES: Traumatic brain injury (TBI) is a major cause of long-term disability
with variable recovery. Pre-clinical 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%
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. This
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