Increased bone resorption in the proximal femur in patients with hemiplegia.
OBJECTIVE
To investigate the relationship between the proximal femoral bone mineral density and bone resorption markers, determinants of calcium metabolism and vitamin D levels in elderly stroke patients.


METHODS
A total of 80 patients and 20 controls were enrolled in the study. Bone mineral density measurements were obtained at the proximal femur. In all subjects, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, deoxypyridinoline, and ionized calcium concentrations were measured. Barthel Index and Motricity Index Leg Score were recorded all patients.


RESULTS
The serum concentrations of deoxypyridinoline, intact parathyroid hormone, and the mean serum ionized calcium levels were significantly higher in patients with stroke than that of the control subjects. The mean serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in patients were significantly lower than those of the control group (P < 0.05). The bone mineral density of proximal femurs of paretic limbs was decreased significantly compared with those of the control group (P < 0.05). There were significant correlations between the Z score of the hemiplegic side and the patients' Barthel Index, Motricity Index Leg Score, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, calcium, and deoxypyridinoline.


CONCLUSIONS
This study provides clear evidence that decreased mobility, vitamin D status, and bone turnover variables in patients after stroke are important factors in the greater bone loss in the paretic leg.
Levendoglu
Funda
F
Department of Physical Medicine and Rehabilitation, Meram School of Medicine, Selcuk University, Konya, Turkey.
Ugurlu
Hatice
H
Gürbilek
Mehmet
M
Akkurt
Ekrem
E
Karagözolu
Emrah
E
D000368:Aged; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001862:Bone Resorption / Q000097:blood* / Q000503:physiopathology*; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005269:Femur / Q000503:physiopathology*; D006429:Hemiplegia / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D012016:Reference Values; D012044:Regression Analysis; D014807:Vitamin D / Q000097:blood
D000596:Amino Acids; D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; C036020:deoxypyridinoline; D003404:Creatinine; D002118:Calcium