Vitamin C Depletion Is Spontaneous Intracerebral Hemorrhage Risk Factor. (S25.005)

Abstract

OBJECTIVE: The purpose of the study was to determine whether vitamin C depletion is a spontaneous intracerebral haemorrhage (ICH) risk factor. BACKGROUND: Scurvy is caused by vitamin C deficiency, specifically a plasma vitamin C concentration < 11 µmol/L, and may have haemorrhagic manifestations. Vitamin C depletion (< 38 µmol/L) is associated with cardiovascular diseases and could increase ICH risk. DESIGN/METHODS: In a prospective case-control study, we measured the plasma vitamin C concentration in 65 consecutive patients with acute ICH and 65 matched controls. For cases, diagnosis and determination of ICH locations were based on the findings of brain imaging. Participants’ plasma ascorbate concentrations were determined via high-performance liquid chromatography. Vitamin C levels were categorized according to limits established in the laboratory: deficiency, depletion, or normal. Demographic, clinical, radiological and biological data were first analysed between cases and controls. Cases data were then analysed according to ICH localization and according to plasma Vitamin C status. RESULTS: A total of 130 participants were thus enrolled. In our cohort, 41% of cases had a normal vitamin C status, 45% showed depletion and 14% deficiency. The mean plasma vitamin C concentration in the population was 45.8 ± 22.6 µmol/L. Patients with intracerebral haemorrhage had vitamin C depletion (35.3 µmol/L ± 19.9 µmol/L); control vitamin C status was normal (56.2 µmol/L ± 20.4 µmol/L) (p<0.001). High blood pressure (p = 0.008), alcohol consumption (p = 0.023) and overweight (p = 0.038) were strong deep intracerebral haemorrhage risk factors. Patients aged 蠅 75 years had more lobar than deep intracerebral haemorrhages (p = 0.014). Vitamin C depletion was not associated with acute or 3-month mortality but was associated with longer hospitalization (p = 0.026). CONCLUSIONS: Vitamin C depletion is a spontaneous ICH risk factor. There are multiple physiopathological mechanisms given the involvement of vitamin C in blood pressure regulation and collagen synthesis. Additional work is required to confirm our findings. Study Supported by:

Disclosure: Dr. Vannier has nothing to disclose. Dr. Thomas has nothing to disclose. Dr. Jean-christophe has nothing to disclose. Dr. Pinel has nothing to disclose. Dr. Verin has nothing to disclose.