Patients with both elevated hsCRP and vitamin D deficiency showed the highest odds of poor short-term functional outcomes after acute ischemic stroke, with adjusted odds ratios up to 12.54, and a simple count of these adverse markers may help identify higher-risk patients.
Serum 25-hydroxyvitamin D levels fell stepwise as hsCRP levels rose among acute ischemic stroke patients.
High hsCRP was independently associated with poorer scores on multiple functional and cognitive outcome measures at discharge.
Patients with both high hsCRP and vitamin D deficiency formed the highest-risk group for poor short-term functional outcomes, with adjusted odds ratios up to 12.54.
A significant additive interaction between high hsCRP and vitamin D deficiency was found specifically for cognitive impairment, but no significant multiplicative interaction was observed for any outcome.
The authors propose that a simple count of adverse biomarker categories (elevated hsCRP and vitamin D deficiency) may serve as a clinically practical tool to stratify stroke patients by risk.
This research suggests that two blood biomarkers — high-sensitivity C-reactive protein (hsCRP, a marker of inflammation) and vitamin D levels — together provide useful information about how well patients recover in the short term after a stroke. Among 192 stroke patients, those with both high inflammation (high hsCRP) and low vitamin D were far more likely to have poor physical function, poor balance, worse hand function, impaired cognition, and greater disability at hospital discharge compared to patients with neither risk factor. The odds of poor outcomes were up to about 12.5 times higher in patients with both adverse markers compared to those with neither. The study also found that as hsCRP levels rose, vitamin D levels tended to fall — suggesting these two factors may be biologically linked. Importantly, the two markers appeared to add to each other's negative effects (additive interaction) for cognitive outcomes specifically, though they did not appear to multiply each other's risks in a statistically significant way. This means that having both risk factors is worse than having either alone, but the combined effect appears to be roughly additive rather than synergistic. This research suggests that simply counting how many of these two adverse markers a stroke patient has could be a practical and low-cost way to identify who is at greatest risk of poor recovery. The authors note this could help clinicians target closer monitoring or identify patients who might benefit from future clinical trials testing whether vitamin D supplementation improves stroke recovery outcomes.
Choi S, Rho Y, Kim M, Yoo M, Shim G, Lee J, et al.. (2026). Combined Association of High-Sensitivity C-Reactive Protein and Vitamin D with Short-Term Functional Outcomes in Acute Ischemic Stroke.. Nutrients. https://doi.org/10.3390/nu18193244