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Published on: December 29, 2023
Accelerated bone remodeling in patients with poststroke hemiplegia.
1Department of Neurology, Futase Social Insurance Hospital, Iizuka, Japan.
Summary
Stroke patients experience bone loss on the hemiplegic side due to vitamin D deficiency. This leads to accelerated bone remodeling and osteopenia, potentially treatable with vitamin D and bone resorption inhibitors.
Area of Science:
- Orthopedics
- Endocrinology
- Neurology
Background:
- Stroke-induced hemiplegia causes disuse and vitamin D deficiency, leading to bone-mass reduction.
- Osteopenia in hemiplegic limbs increases hip fracture risk, predominantly on the affected side.
Purpose of the Study:
- To evaluate bone mineral density (BMD) and related biochemical markers in stroke patients with hemiplegia.
- To understand the mechanisms of osteopenia in hemiplegic limbs.
Main Methods:
- Assessed BMD of the second metacarpals in 61 stroke patients and 28 controls.
- Measured serum levels of intact parathyroid hormone (PTH), osteocalcin (OC), tartrate-resistant acid phosphatase (TRAP), 25-hydroxyvitamin D (25-OHD), and calcium.
Main Results:
- BMD was higher on the hemiplegic side compared to the nonhemiplegic side.
- Hemiplegic BMD correlated positively with PTH, OC, and TRAP, and negatively with 25-OHD.
- Serum 25-OHD was low, while PTH, OC, and TRAP were elevated in patients compared to controls.
Conclusions:
- Accelerated skeletal remodeling with predominant resorption occurs in hemiplegic limbs.
- Vitamin D deficiency and secondary hyperparathyroidism contribute to osteopenia in stroke patients.
- Treatment with etidronate and vitamin D may correct hemiplegic limb osteopenia.
