The impact of low muscle mass and bone mineral density on acute ischemic stroke outcome

Due to the neurologic damage caused, acute ischemic stroke is considered to be amongst the most important causes of disability and loss of work power both in our country and in the World. The disability caused by ischemic stroke is often referred to the neurologic impairment, yet being the effector organ of all locomotive activity, the musculoskeletal system health is also thought to be an important contributor into the stoke outcome. Our study aims to investigate the impact of low muscle mass and bone mineral density regarding the acute ischemic stroke outcome. In this regard, we included 307 patients that presented to our hospital with acute ischemic stroke diagnosis in our study, and we gathered their outcome information one year after the stroke event. In our cohort, osteoporosis prevalence was 40,5% for females and 12,7% for males; low muscle mass prevalences were between 11,6% and 79,0% for females and between 17,1% and 33,8% for males and osteosarcopenia prevalences were between 12,1% and 67,2% for females and between 13,4% and 30,4% for males according to different definitions used. Multivariate analysis revealed that while osteoporosis was an independent risk factor, high muscle mass was protective against mortality for males. Low rectus femoris cross sectional area was found to be associated with worse outcome. Lastly, osteosarcopenia presence had an impact on stroke outcome for both sexes, according to different definitions used. As a result, our study showed that pre-stroke musculoskeletal health was associated with acute ischemic stroke outcome. Yet, this association remains to be re-assessed with standardized cut-off values and with greater numbers.