Correlation analysis of serum 25(OH)D levels with white matter hyperintensities and gait disorders in patients with cerebral small vessel disease

The correlations between the serum 25(OH)D level with white matter hyperintensities (WMH) and gait disorders were determined in patients with cerebral small vessel disease. Patients with WMH (n = 217) were enrolled, while 52 healthy individuals were designated as the control group. The 217 patients populated the vitamin D deficiency, insufficiency, and sufficiency groups. The 217 patients with WMH were also divided into periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH) groups. The serum 25(OH)D level was negatively correlated with the severity of WMH, especially PWMH (P < 0.05). A significant difference in gait existed among the groups with different 25(OH)D levels and the control group (all P < 0.001). All indicators had statistical significance between the 25(OH)D insufficiency and deficiency groups, between the 25(OH)D sufficiency and deficiency groups, and the control and 25(OH)D deficiency groups. The serum 25(OH)D level was positively correlated with the total SPPB score, the total Tinetti balance and gait analysis (TBGA) score (P < 0.05), but negatively correlated with TUG time (P < 0.05). The combination of WMH severity and the serum 25(OH)D level more effectively indicated the falling risk than a single indicator, with an AUC value of 0.806. Logistic regression analysis showed that 25(OH)D, age, whether a cerebral infarction had occurred, hypertension, and smoking were the significant influencing factors for WMH (P < 0.05); and gender, age, presence of coronary heart disease, total score of WMH, and 25(OH)D had significant impacts on falls (P < 0.05). The serum 25(OH)D level had a negative correlation with WMH, especially PWMH. The serum 25(OH)D level was negatively correlated with gait disorders. The combination of WMH severity and serum 25(OH)D level was more discriminative at identifying low-risk versus high-risk falling groups than relying on a single indicator. 25(OH)D and age were significant influencing factors for WMH, as well as for the falls.