Hemiosteoporosis after severe stroke, independent of changes in body composition and weight

• Published in: Stroke (1970) Vol. 30; no. 4; pp. 755 - 760
• Main Authors: RAMNEMARK, A, NYBERG, L, LORENTZON, R, OLSSON, T, GUSTAFSON, Y
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.04.1999; American Heart Association, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Body Composition; Body Weight; Bone Density; Cerebrovascular Disorders - complications; Female; Follow-Up Studies; Hemiplegia - complications; Humans; Male; Medical sciences; Neurology; Osteoporosis - etiology; Paresis - complications; Vascular diseases and vascular malformations of the nervous system; Human; Nervous system diseases; Stroke; Pathogenesis; Diseases of the osteoarticular system; Cardiovascular disease; Bone disease; Density; Body composition; Cerebral disorder; Vascular disease; Osteoporosis; Central nervous system disease; Dual energy absorptiometry; Unilateral; Adult; Complication; Evolution; Bone; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/01.str.30.4.755

Fractures are a serious complication after stroke, and the risk of hip fractures among stroke patients is increased 2 to 4 times versus a reference population. Fractures after stroke are probably caused by the development of hemiosteoporosis and the high incidence of accidental falls. The aim of this study was to investigate the development of hemiosteoporosis in relation to other changes in body composition during the first year after severe stroke. The study included 24 patients with extensive paresis after stroke. Bone mineral content (BMC) and fat and lean mass were assessed 1, 4, 7, and 12 months after stroke onset by a dual-energy x-ray absorptiometer. The loss of total body BMC was significant during the first year after stroke (-1.6%; P<0.05), but there were no significant changes in total lean or fat mass. At inclusion, there were no significant differences between sides in lean or fat mass or BMC, but during follow-up, BMC of the affected side decreased significantly compared with the same side at inclusion (-7.5%; P<0.01). Side differences in fat mass became significant between legs (9.3%; P<0.001) and whole sides (4. 8%; P<0.01). There were only minor side changes in lean mass. Loss of BMC was independent of weight changes. During the first year after severe stroke, patients developed pronounced hemiosteoporosis. This was not associated with general changes in lean or fat mass. The development of hemiosteoporosis was independent of weight changes after stroke.