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The predictive value of serum 25(OH)D, AQP4, and IL-4 levels for edema volume and clinical prognosis after traumatic brain injury

Year: 2026

Type: article

Abstract: Objective This 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). Methods A 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. Results Serum 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. Conclusion Serum 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.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1788253

Authors: Yuanpeng Wang, Zhiying Ding, Lixiang Yang, Yunna Tao, Yanhong Song

Institutions: Wuxi Taihu Hospital, Wuxi People's Hospital, Nanjing Medical University

Language: English

Topic: Traumatic Brain Injury and Neurovascular Disturbances

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801