Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke
(1) Introduction: Iron deficiency (ID) contributes to impaired functional performance and reduced quality of life in patients with chronic illnesses. The role of ID in stroke is unclear. The aim of this prospective study was to evaluate the prevalence of ID and to evaluate its association with long-...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-01-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/3/595 |
| _version_ | 1797486949745819648 |
|---|---|
| author | Nadja Scherbakov Anja Sandek Miroslava Valentova Antje Mayer Stephan von Haehling Ewa Jankowska Stefan D. Anker Wolfram Doehner |
| author_facet | Nadja Scherbakov Anja Sandek Miroslava Valentova Antje Mayer Stephan von Haehling Ewa Jankowska Stefan D. Anker Wolfram Doehner |
| author_sort | Nadja Scherbakov |
| collection | DOAJ |
| description | (1) Introduction: Iron deficiency (ID) contributes to impaired functional performance and reduced quality of life in patients with chronic illnesses. The role of ID in stroke is unclear. The aim of this prospective study was to evaluate the prevalence of ID and to evaluate its association with long-term functional outcome in patients with ischemic stroke. (2) Patients and Methods: 140 patients (age 69 ± 13 years, BMI 27.7 ± 4.6 kg/m², mean ± SD) admitted to a university hospital stroke Unit, with acute ischemic stroke of the middle cerebral artery were consecutively recruited to this observational study. Study examinations were completed after admission (3 ± 2 days after acute stroke) and at one-year follow up (<i>N</i> = 64, 382 ± 27 days after stroke). Neurological status was evaluated according to the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS). Muscle isometric strength of the non-affected limb was assessed by the maximum handgrip test and knee extension leg test. ID was diagnosed with serum ferritin levels ≤ 100 µg/L (ID Type I) or 100–300 µg/L if transferrin saturation (TSAT) < 20% (ID Type II). (3) Results: The prevalence of ID in acute stroke patients was 48% (<i>N</i> = 67), with about two-thirds of patients (<i>N</i> = 45) displaying ID Type I and one-third (<i>N</i> = 22) Type II. Handgrip strength (HGS) and quadriceps muscle strength were reduced in patients with ID compared to patients without ID at baseline (HGS: 26.5 ± 10.4 vs. 33.8 ± 13.2 kg, <i>p</i> < 0.001 and quadriceps: 332 ± 130 vs. 391 ± 143 <i>N</i>, <i>p</i> = 0.06). One year after stroke, prevalence of ID increased to 77% (<i>p =</i> 0.001). While an improvement of HGS was observed in patients with normal iron status, patients with ID had no improvement in HGS difference (4.6 ± 8.3 vs. −0.7 ± 6.5 kg, <i>p</i> < 0.05). Patients with ID remained with lower HGS compared to patients with normal iron status (28.2 ± 12.5 vs. 44.0 ± 8.6 kg, <i>p</i> < 0.0001). (4) Conclusions: Prevalence of ID was high in patients after acute stroke and further increased one year after stroke. ID was associated with lower muscle strength in acute stroke patients. In patients with ID, skeletal muscle strength did not improve one year after stroke. |
| first_indexed | 2024-03-09T23:41:35Z |
| format | Article |
| id | doaj.art-24bf8d4ca54f4f1eb2db674952bc1aa7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:41:35Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-24bf8d4ca54f4f1eb2db674952bc1aa72023-11-23T16:50:56ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111359510.3390/jcm11030595Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic StrokeNadja Scherbakov0Anja Sandek1Miroslava Valentova2Antje Mayer3Stephan von Haehling4Ewa Jankowska5Stefan D. Anker6Wolfram Doehner7Berlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, GermanyDepartment of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, GermanyDepartment of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, GermanyBerlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, GermanyDepartment of Cardiology and Pneumology, University of Göttingen, 37073 Göttingen, GermanyInstitute of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, PolandBerlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, GermanyBerlin Institute of Health, Center for Regenerative Therapies (BCRT), Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany(1) Introduction: Iron deficiency (ID) contributes to impaired functional performance and reduced quality of life in patients with chronic illnesses. The role of ID in stroke is unclear. The aim of this prospective study was to evaluate the prevalence of ID and to evaluate its association with long-term functional outcome in patients with ischemic stroke. (2) Patients and Methods: 140 patients (age 69 ± 13 years, BMI 27.7 ± 4.6 kg/m², mean ± SD) admitted to a university hospital stroke Unit, with acute ischemic stroke of the middle cerebral artery were consecutively recruited to this observational study. Study examinations were completed after admission (3 ± 2 days after acute stroke) and at one-year follow up (<i>N</i> = 64, 382 ± 27 days after stroke). Neurological status was evaluated according to the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS). Muscle isometric strength of the non-affected limb was assessed by the maximum handgrip test and knee extension leg test. ID was diagnosed with serum ferritin levels ≤ 100 µg/L (ID Type I) or 100–300 µg/L if transferrin saturation (TSAT) < 20% (ID Type II). (3) Results: The prevalence of ID in acute stroke patients was 48% (<i>N</i> = 67), with about two-thirds of patients (<i>N</i> = 45) displaying ID Type I and one-third (<i>N</i> = 22) Type II. Handgrip strength (HGS) and quadriceps muscle strength were reduced in patients with ID compared to patients without ID at baseline (HGS: 26.5 ± 10.4 vs. 33.8 ± 13.2 kg, <i>p</i> < 0.001 and quadriceps: 332 ± 130 vs. 391 ± 143 <i>N</i>, <i>p</i> = 0.06). One year after stroke, prevalence of ID increased to 77% (<i>p =</i> 0.001). While an improvement of HGS was observed in patients with normal iron status, patients with ID had no improvement in HGS difference (4.6 ± 8.3 vs. −0.7 ± 6.5 kg, <i>p</i> < 0.05). Patients with ID remained with lower HGS compared to patients with normal iron status (28.2 ± 12.5 vs. 44.0 ± 8.6 kg, <i>p</i> < 0.0001). (4) Conclusions: Prevalence of ID was high in patients after acute stroke and further increased one year after stroke. ID was associated with lower muscle strength in acute stroke patients. In patients with ID, skeletal muscle strength did not improve one year after stroke.https://www.mdpi.com/2077-0383/11/3/595iron deficiencyprevalenceacute ischemic strokechronic strokemuscle strengthfunctional outcome |
| spellingShingle | Nadja Scherbakov Anja Sandek Miroslava Valentova Antje Mayer Stephan von Haehling Ewa Jankowska Stefan D. Anker Wolfram Doehner Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke Journal of Clinical Medicine iron deficiency prevalence acute ischemic stroke chronic stroke muscle strength functional outcome |
| title | Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke |
| title_full | Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke |
| title_fullStr | Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke |
| title_full_unstemmed | Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke |
| title_short | Iron Deficiency and Reduced Muscle Strength in Patients with Acute and Chronic Ischemic Stroke |
| title_sort | iron deficiency and reduced muscle strength in patients with acute and chronic ischemic stroke |
| topic | iron deficiency prevalence acute ischemic stroke chronic stroke muscle strength functional outcome |
| url | https://www.mdpi.com/2077-0383/11/3/595 |
| work_keys_str_mv | AT nadjascherbakov irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT anjasandek irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT miroslavavalentova irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT antjemayer irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT stephanvonhaehling irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT ewajankowska irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT stefandanker irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke AT wolframdoehner irondeficiencyandreducedmusclestrengthinpatientswithacuteandchronicischemicstroke |