Low concentration of serum vitamin B12 may be a strong predictor of large-artery atherosclerosis stroke: A case-control study

Introduction

Identifying controllable risk factors for large-artery atherosclerosis (LAA) stroke is crucial due to its significant role as a leading cause of ischemic stroke. We aimed to validate the correlation of serum vitamin B₁₂ with LAA stroke.

Methods

Inpatients with LAA stroke and healthy controls were retrospectively collected for a case-control study from January 2020 to May 2022. Serum vitamin B₁₂ concentration and other blood indicators, demographic, lifestyle factors and comorbidities were investigated. Logistic regression analysis was used to identify the correlation of serum vitamin B₁₂ concentrations with LAA stroke, meanwhile adjusted for confounding factors.

Results

Patients with LAA stroke had significantly lower serum vitamin B₁₂ concentrations in comparison to those of controls. In the fully adjusted model, vitamin B₁₂ (per 1 interquartile range increase, odds ratio [OR] = 0.84, 95 % confidence interval [CI]: 0.77–0.91), vitamin B₁₂ < 200 pg/mL (OR=7.70, 95 %CI: 2.19–27.03) and vitamin B₁₂ < 300 pg/mL (OR=4.19, 95 %CI: 1.82–9.66) were independently factors for LAA stroke. Furthermore, the optimal cut-off values for vitamin B₁₂ to predict LAA stroke were 305.25 pg/mL (area under the curve [AUC] = 0.71) when unadjusted and 308.25 pg/mL when adjusted for age and sex (AUC=0.68). Lower vitamin B₁₂ concentrations were significantly associated with male sex, smoking, older age, higher neutrophil count, higher creatinine, lower folate and higher total homocysteine.

Conclusion

Results indicate that low concentration of serum vitamin B₁₂ may be a strong predictor for the risk of LAA stroke.