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Query: UMLS:C0018991 (
hemiplegia
)
3,997
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The significant bone-mass reduction that occurs on the hemiplegic side of stroke patients due to disuse and vitamin D deficiency may explain the increased post-stroke incidence of hip fractures. To further evaluate this osteopenia, the Z-score of bone mineral density (BMD) in both second metacarpals was assessed in 54 stroke patients and 27 control subjects. Serum concentrations of intact parathyroid hormone (PTH), osteocalcin (OC),
tartrate-resistant acid phosphatase
(
TRAP
) and 25-hydroxyvitamin D (25-OHD) were also determined. The patients' Z-scores were lower on the hemiplegic side than on the nonhemiplegic side. Serum concentrations of PTH, OC and
TRAP
exceeded those in control subjects. Serum 25-OHD was reduced in patients and correlated negatively with the Z-score on the hemiplegic side. Serum PTH was elevated markedly in 17% of the patients and correlated positively with the levels of OC, but not with
TRAP
, 25-OHD or the Z-scores on both sides. The results indicate that skeletal remodeling is accelerated in patients with
hemiplegia
and suggest that vitamin D deficiency and insufficient compensatory hyperparathyroidism stimulating skeletal turnover is an important cause of osteopenia in immobilized stroke patients.
...
PMID:Role of the parathyroid gland on bone mass and metabolism in immobilized stroke patients. 978 97
A significant bone-mass reduction occurs on the hemiplegic side of stroke patients because of disuse and vitamin D deficiency. This may explain why hip fractures in poststroke patients occur almost exclusively on the hemiplegic side. To further evaluate this osteopenia, bone mineral density (BMD) in both second metacarpals was assessed in 61 patients and 28 control subjects. Serum concentrations of intact parathyroid hormone (PTH), osteocalcin (OC),
tartrate-resistant acid phosphatase
(
TRAP
), 25-hydroxyvitamin D (25-OHD), and calcium also were determined. The patients' BMD values were higher on the hemiplegic side than on the nonhemiplegic side. BMD on the hemiplegic side correlated positively with serum concentrations of PTH, OC and
TRAP
, which exceeded those in control subjects. Serum 25-OHD was low in patients, correlating negatively with BMD on the hemiplegic side. Serum PTH correlate positively with the levels of OC and
TRAP
and negatively with 25-OHD concentrations. The results indicate that skeletal remodeling is accelerated in patients with
hemiplegia
, with resorption predominating. We concluded that vitamin D deficiency and compensatory secondary hyperparathyroidism stimulating skeletal turnover is an important cause of osteopenia in the hemiplegic limbs of stroke patients. This osteopenia might be corrected by administration of etidronate to inhibit osteoclastic bone resorption together with a vitamin D supplement.
...
PMID:Accelerated bone remodeling in patients with poststroke hemiplegia. 3178 24