Bone mineral density and fragility fractures in stroke patients
DOI:
https://doi.org/10.14739/2310-1210.2019.6.186503Keywords:
stroke, bone mineral density, osteoporosis, fractureAbstract
The aim was to study the parameters of bone mineral density (BMD) and frequency of fragility fractures in males and females with ischemic stroke depending on a side of brain injury and duration of post-stroke period.
Materials and methods. We examined 140 patients aged 50–80 years old, divided into 2 groups: I – subjects without any diseases influencing the bone state and II – patients after ischemic stroke. BMD indexes (BMDs) were measured using dual-energy X-ray absorbtiometry method.
Results. The males with stroke had significantly lower parameters of total body, upper extremity and trunk BMDs compared to indexes of the control group without any differences in lower extremities BMDs in contrast to women with stroke who had lower BMDs of total body, trunk and upper/lower extremities compared to parameters of the control group. Almost all measured BMDs were significantly lower on a paretic side compared to BMDs on a non-paretic side, except distal radius and total lower extremities BMDs in men with stroke in contrast to women who demonstrated significantly lower femoral neck and total femur BMDs compared to the control group. Most BMDs were decreased in females with post-stroke period duration of more than 1 year in contrast to data in men who did not show any BMD differences, except significantly decreased BMD of upper extremities compared to the control group. Fragility fractures were revealed in 21.4 % of patients after stroke (31.8 % in women and 10.0 % in men, P < 0.05), their frequency was higher only in women compared to the control group patients.
Conclusions. BMDs in stroke patients are lower and frequency of osteoporosis is higher with some sex differences that should be taken into account in their assessment and development of rehabilitation programs for older age subjects.
References
Carda, S., Cisari, C., Invernizzi, M., & Bevilacqua, M. (2009). Osteoporosis after stroke: a review of the causes and potential treatments. Cerebrovascular Diseases, 28(2), 191-200. doi: 10.1159/000226578
Laroche, M., Pécourneau, V., Blain, H., Breuil, V., Chapurlat, R., & Cortet, B. et al. (2017). Osteoporosis and ischemic cardiovascular disease. Joint Bone Spine, 84(4), 427-432. doi: 10.1016/j.jbspin.2016.09.022
Huo, K., Hashim, S. I., Yong, K. L., Su, H., Qu, Q. M. (2016). Impact and risk factors of post-stroke bone fracture. World Journal Of Experimental Medicine, 6(1), 1-8. doi: 10.5493/wjem.v6.i1.1
Girijala, R., Sohrabji, F., & Bush, R. (2016). Sex differences in stroke: review of current knowledge and evidence. Vascular Medicine, 22(2), 135-145. doi: 10.1177/1358863x16668263
Ahnstedt, H., McCullough, L., & Cipolla, M. (2016). The importance of considering sex differences in translational stroke research. Translational Stroke Research, 7(4), 261-273. doi: 10.1007/s12975-016-0450-1
Alswat, K. (2017). Gender disparities in osteoporosis. Journal Of Clinical Medicine Research, 9(5), 382-387. doi: 10.14740/jocmr2970w
Kim, H., Kim, S., Kim, D., Jeong, H., Sim, Y., & Kim, G. (2016). Change of bone mineral density and relationship to clinical parameters in male stroke patients. Annals Of Rehabilitation Medicine, 40(6), 981-988. doi: 10.5535/arm.2016.40.6.981
Schnitzer, T., Harvey, R., Hillary Nack, S., Supanwanid, P., Maskala-Streff, L., & Roth, E. (2012). Bone mineral density in patients with stroke: relationship with motor impairment and functional mobility. Topics In Stroke Rehabilitation, 19(5), 436-443. doi: 10.1310/tsr1905-436
Lee, J., Jeon, H., Park, J., Han, K., Kim, J., & Yoon, J. et al. (2017). Sex differences in the association between stroke and bone mineral density in elderly Koreans: The Korean National Health and Nutrition Examination Survey, 2008-2010. Maturitas, 95, 1-5. doi: 10.1016/j.maturitas.2016.10.006
Min, D., Lee, J., Choe, H., Kim, E., Shin, S., & Lee, J. (2016). Comparison of bone density on the dominant and nondominant sides between healthy elderly individuals and stroke patients. Journal Of Physical Therapy Science, 28(9), 2533-2536. doi: 10.1589/jpts.28.2533
Wei, M., Lyu, H., Huo, K., & Su, H. (2018). Impact of bone fracture on ischemic stroke recovery. International Journal Of Molecular Sciences, 19(5), 1533. doi: 10.3390/ijms19051533
Lin, H., Lin, H., Tseng, Y., Liao, H., Worly, J., Pan, C., & Hsu, C. (2014). Hip fracture after first-ever stroke: a population-based study. Acta Neurologica Scandinavica, 131(3), 158-163. doi: 10.1111/ane.12301
Kapral, M., Fang, J., Alibhai, S., Cram, P., Cheung, A., & Casaubon, L. et al. (2016). Risk of fractures after stroke. Neurology, 88(1), 57-64. doi: 10.1212/wnl.0000000000003457
Benzinger, P., Rapp, K., König, H., Bleibler, F., Globas, C., & Beyersmann, J. et al. (2015). Risk of osteoporotic fractures following stroke in older persons. Osteoporosis International, 26(4), 1341-1349. doi: 10.1007/s00198-014-3005-x
National Institutes of Health Stroke Scale. Retrieved from https://www.stroke.nih.gov/documents/NIH_Stroke_Scale.pdf.
ISCD Official Positions – Adult. Retrieved from https://www.iscd.org/official-positions/2015-iscd-official-positions-adult/
Bystrytska, M. A. (2018). Mineralna shchilnist kistkovoi tkanyny, zhyrova ta znezhyrena masa u patsiientiv, yaki perenesly mozkovyi insult [Bone mineral density, fat and lean mass in stroke patient]. International Neurological Journal, 5, 66-71. [in Ukrainian].
Povorozniuk, V. V., Bystrytska, M. A., & Koshel, N. M. (2018). Osteoporoz u patsiientiv, yaki perenesly mozkovyi insult [Osteoporosis in stroke patients]. TRAUMA, 19(6), 48-53. doi: 10.22141/1608-1706.6.19.2018.152220
Andersson, A. G., Seiger, A., & Appelros, P. (2013). Hip fractures in persons with stroke. Stroke Research And Treatment, 2013, 954279. doi: 10.1155/2013/954279
Dennis, M., Lo, K., McDowall, M., & West, T. (2002). Fractures after stroke. Stroke, 33(3), 728-734. doi: 10.1161/hs0302.103621
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