# Insights into Iron Metabolism Parameters in Ischemic Stroke: A Single-Center Prospective Cohort Study

## TL;DR

This study explores changes in iron metabolism biomarkers in patients with ischemic stroke, finding elevated ferritin and hemojuvelin levels over time.

## Contribution

The study provides new insights into iron metabolism dynamics in ischemic stroke patients, particularly highlighting sHJV and ferritin changes.

## Key findings

- Ferritin levels increased significantly on the 7th day post-stroke in the entire study group and thrombolysis subgroup.
- Hepcidin levels decreased significantly on the 7th day, but only in the entire study group.
- sHJV levels were significantly higher in patients with PACI stroke and those treated with thrombolysis.

## Abstract

The hemojuvelin–hepcidin regulatory axis may play a key role in the iron metabolism both systemically and locally. There is a pressing need to evaluate this tightly regulated network of iron parameters and their potential impact on the development of ischemic stroke (IS). We aimed to assess iron metabolism biomarkers in patients after IS, evaluating changes over time and considering their clinical features. We studied 45 patients diagnosed with IS. We assessed major iron metabolism parameters, such as hepcidin, soluble hemojuvelin (sHJV), soluble transferrin receptor (sTfR), and ferritin, using immunoenzymathic methods at two time points: on admission and on the 7th day post IS. We found increased ferritin levels on the 7th day post IS compared to admission, and this was observed in the entire study group (p = 0.03) and in the subgroup treated with thrombolysis (p = 0.02). The hepcidin levels, on the other hand, showed a significant decrease on the 7th day, though this difference was only evident in the entire study group (p = 0.04). We also discovered significantly elevated sHJV levels in patients with PACI stroke compared to other stroke locations, both on admission and on the 7th day post IS (p < 0.05). Significantly higher sHJV levels were observed in patients treated with thrombolysis compared to those receiving conventional treatment, regardless of the time point (p < 0.0001 and p = 0.0002, respectively). Our study revealed changes in the iron metabolism parameters during stroke. The patients with anterior cerebral infarction and those treated with thrombolysis presented significantly elevated sHJV levels.