VITAMIN-D DEFICIENCY AND OSTEOPENIA IN THE HEMIPLEGIC LIMBS OF STROKEPATIENTS

Background and Purpose Little is known about bone changes in hemiplegi c stroke patients. We evaluated the vitamin D status and bone changes on the hemiplegic and intact sides of stroke patients. Methods Sera we re collected from 87 hemiplegic stroke patients (42 outpatients and 45 inpatients) and from 28 control subjects. The sera were assayed for 2 5-hydroxyvitamin D (25-OHD). Bone density was measured bilaterally fro m radiographs of the hands. Diet and sunlight exposure were assessed f or all subjects. Results Serum 25-OHD concentrations were lower in pat ients (9.1 +/- 4.9 ng/mL for outpatients, 5.9 +/- 4.1 ng/mL for inpati ents) than in control subjects (21.6 +/- 3.1 ng/mL). The difference in serum 25-OHD between the two patient groups also was statistically si gnificant. The patients' microdensitometric scores for osteopenia were higher on the hemiplegic side than on the non-hemiplegic side. The mi crodensitometric scores and their side-to-side differences in patients correlated negatively with the serum 25-OHD concentration and positiv ely with the degree of paralysis. Dietary intake of vitamin D was belo w the recommended level in 72% of the patients, and 89% of the patient s were considered sunlight-deprived. Conclusions Bone mass was reduced significantly on the hemiplegic side in the stroke patients, which mi ght increase the risk of hip fracture. Vitamin D deficiency and disuse are the probable causes of osteopenia in this population. The hypovit aminosis D might be corrected readily by routine use of vitamin D supp lements.