Serum 25(OH)D, AQP4, and IL-4 levels tracked after traumatic brain injury
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Key Takeaway
Consider serum 25(OH)D on day 1 as a potential prognostic indicator in TBI, noting observational limitations.
This observational cohort study enrolled 279 patients with traumatic brain injury (TBI) during hospital admission between January 2023 and December 2024. Researchers measured serum 25(OH)D, AQP4, and IL-4 levels on days 1, 3, and 7 post-admission and compared a favorable outcome group (n=215) to a poor outcome group (n=64) based on 90-day follow-up.
Main results showed serum 25(OH)D levels were highest on day 1 post-TBI and decreased over time (P < 0.05). AQP4 and IL-4 levels were lowest on day 1 and increased significantly by days 3 and 7 (P < 0.05). An inverse correlation was found between serum 25(OH)D and brain edema volume (P < 0.05), while AQP4 and IL-4 levels showed a positive correlation with edema volume (P < 0.05).
In the favorable vs poor outcome groups, serum 25(OH)D levels were higher on days 1, 3, and 7 (P < 0.05), while AQP4 and IL-4 levels were lower (P < 0.05). Multivariate analysis indicated serum 25(OH)D on day 1 and Glasgow Coma Scale score were associated with favorable outcomes, whereas IL-4 levels on day 1 independently predicted poor prognosis (P < 0.05). ROC analysis suggested all tested biomarkers had prognostic value, with serum 25(OH)D on day 1 showing the highest predictive accuracy.
No adverse events, serious adverse events, discontinuations, or tolerability data were reported. Key limitations include the observational design, which cannot establish causation; the single-center setting, which may limit generalizability; and the lack of a control group for interventions. Practice relevance suggests serum 25(OH)D levels on day 1 post-injury may serve as a prognostic indicator for TBI outcomes, but findings are based on associations and should not guide interventions.
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View Original Abstract ↓
ObjectiveThis study aims to explore the associations between serum 25-hydroxyvitamin D (25(OH)D), aquaporin 4 (AQP4), and interleukin-4 (IL-4) levels with brain edema volume and outcomes in patients with traumatic brain injury (TBI).MethodsA cohort of 279 TBI patients, enrolled between January 2023 and December 2024, was analyzed. Serum levels of 25(OH)D, AQP4, and IL-4, as well as brain edema volume, were measured on days 1, 3, and 7 post-admission. Pearson correlation analysis was used to assess relationships between these serum markers and brain edema volume. Based on the 90-day follow-up outcome, patients were classified into a favorable outcome group (n = 215) and a poor outcome group (n = 64). Multivariate logistic regression was employed to identify factors influencing TBI outcomes.ResultsSerum 25(OH)D levels were highest on day 1 post-TBI, followed by day 3 and day 7 (P < 0.05). In contrast, AQP4 and IL-4 levels, along with brain edema volume, were lowest on day 1 and increased significantly by days 3 and 7 (P < 0.05). Serum 25(OH)D levels were inversely correlated with brain edema volume, while AQP4 and IL-4 levels exhibited a positive correlation (P < 0.05). On days 1, 3, and 7, the favorable outcome group had higher serum 25(OH)D levels and lower AQP4 and IL-4 levels compared to the poor outcome group (P < 0.05). Multivariate analysis revealed that serum 25(OH)D on day 1 and the Glasgow Coma Scale (GCS) score were associated with favorable outcomes, whereas IL-4 levels on day 1 independently predicted poor prognosis (P < 0.05). ROC curve analysis demonstrated that all tested biomarkers had prognostic value, with serum 25(OH)D on day 1 showing the highest predictive accuracy.ConclusionSerum levels of 25(OH)D, AQP4, and IL-4 are significantly associated with brain edema volume in TBI patients. Among these markers, serum 25(OH)D levels on the first day post-injury serve as the most reliable prognostic indicator of patient outcomes.
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