Review Article
Malnutrition in Patients with Acute Stroke
Table 1
Micronutrients and mechanisms through which their deficiencies induce cerebrovascular alterations and increase the risk of stroke.
| Micronutrient | Mechanism |
| Folic acid | | Cofactor in homocysteine metabolism | Hyperhomocysteinemia (potentially atherogenic) |
| B vitamins | | (i) B6 and B12: cofactors in homocysteine metabolism | (i) Hyperhomocysteinemia (potentially atherogenic) | (ii) Potentially antioxidants | (ii) Oxidative stress |
| Vitamin D | | (i) Controls parathormone levels | (i) Secondary hyperparathyroidism: | (ii) Suppresses cholesterol uptake by the macrophages and foam cell formation | – Insulin resistance and pancreatic b-cell dysfunctiontype 2 diabetes mellitus
| – Activation of the rennin-angiotensin-aldosterone systemhypertension | (iii) Increases the size of high-density lipoprotein particles | – Stimulation of systemic and vascular inflammationatherogenesis | (ii) Atherogenesis |
| Vitamins A, C, and E | | Antioxidants | Oxidative stress |
| Zinc | | (i) Activates brain protein synthesis | (i) Neurocognitive impairment | (ii) Controls newly formed synapses | (ii) Impaired neurotransmission | (iii) Cofactor of superoxide dismutase | (iii) Oxidative stress |
|
|