Abstract T P116: Impact of Serum Nutritional Status on Physical Function in African American and Caucasian Stroke Survivors

Abstract

Difficulties with speech and cognition may interfere with obtaining accurate dietary records to assess dietary quality in those chronically disabled by stroke. Several serum biomarkers commonly found on general comprehensive chemistry panels (e.g. albumin, hemoglobin, uric acid, and lipids) may provide a surrogate clinical indication of nutritional risk when dietary recall is not valid. Thus, the purpose of this study was to determine whether serum nutritional markers differ by race and relate to physical function in stroke. Further, we sought to compare serum profiles in chronic stroke survivors with a representative sample of U.S. Adults (NHANESIII). Fasting serum samples were collected for analysis of lipids, hemoglobin, uric acid, and albumin in 145 African American (AA) and 111 Caucasian (C) stroke survivors (age: 60±1 years [mean±SEM]; BMI: 28 kg/m2). VO2max (N=159), six-minute walk (N=134), 30 foot timed walk (N=161), and isokinetic hamstring strength (N=91) tests were performed in subsets of stroke survivors. VO2max was “very poor” in 96% of stroke survivors and mean walking speed was 40% below recommendations for maintenance of functional independence. Lipids were less favorable in C than AA women stroke survivors (40% higher triglycerides (TG) and 11% lower HDL cholesterol; Ps<0.05). In contrast, serum albumin was 6% lower in AA than C women (P<0.05). Uric acid was ~10% lower in C than AA stroke survivors (P<0.05). These racial differences were similar to that observed in the reference sample, but HDL cholesterol, albumin, and hemoglobin generally were lower (Ps<0.05) in stroke. Lipids were more favorable (~20% lower total cholesterol and ~25% lower TG; Ps<0.01) in stroke, likely due to a high prevalence of lipid lowering medication usage (64%). Uric acid was related to six-minute walk time (r=0.16) and hamstring strength (r=0.20) in stroke survivors (Ps<0.05), suggesting that low uric acid qualifies as a marker worth monitoring in the context of predicting stroke-related functional decline. Although nutritional risk varies according to race in stroke, the racial differences appear similar to a representative U.S. non-stroke sample. Regardless of race, serum nutritional risk does appear elevated in stroke compared to the general population.