中国の多施設共同研究におけるヘモグロビン値とバランス機能の関連性

Balance impairment following stroke is a leading cause of disability and falls. Hemoglobin (Hb) affects systemic and cerebral oxygen delivery and may influence neuromuscular function and post-stroke balance, but evidence from large multicenter clinical samples is limited. We investigated the association between hemoglobin concentration and balance performance in a Chinese multicenter cross-sectional study of stroke patients.

We studied 2,006 neuroimaging-confirmed stroke patients from 26 hospitals. Balance impairment was defined as BBS ≤ 40. Admission Hb (g/dL) was analyzed per 1 g/dL and by tertiles (<12.6 g/dL, 12.6-14.0 g/dL, ≥14.0 g/dL). Multivariable logistic regression with sequential adjustment, restricted cubic splines, and prespecified subgroup and sensitivity analyses evaluated associations.

Balance impairment occurred in 70.5% (1,414/2,006). Each 1 g/dL higher Hb was associated with lower odds of impairment in unadjusted (OR 0.83, 95% CI 0.78-0.87; p < 0.001) and fully adjusted models (OR 0.89, 95% CI 0.83-0.96; p = 0.002). This association remained robust after comprehensive adjustment for demographic, lifestyle, comorbidity, stroke characteristics, and lesion location factors. Compared with the lowest tertile, adjusted ORs were 0.72 (95% CI 0.53-0.99; p = 0.042) for the middle tertile and 0.62 (95% CI 0.45-0.85; p = 0.003) for the highest tertile. Spline analyses suggested a broadly linear inverse association; results were consistent across subgroups and sensitivity checks.

Higher admission hemoglobin was independently associated with better balance after stroke. Prospective studies should test whether Hb optimization improves rehabilitation outcomes.