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

Background and Purpose-Fractures are a serious complication after stroke, a nd the risk of hip fractures among stroke patients is increased 2 to 4 time s versus a reference population. Fractures after stroke are probably caused by the development of hemiosteoporosis and the high incidence of accidenta l falls. The aim of this study was to investigate the development of hemios teoporosis in relation to other changes in body composition during the firs t year after severe stroke. Methods-The study included 24 patients with extensive paresis after stroke. Bone mineral content (BMC) and fat and lean mass were assessed 1, 4, 7, an d 12 months after stroke onset by a dual-energy x-ray absorptiometer, Results-The loss of total body BMC was significant during the first year af ter 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 betwe en sides in lean or fat mass or BMC, but during follow-up, BMC of the affec ted side decreased significantly compared with the same side at inclusion ( -7.5%; P<0.01). Side differences in fat mass became significant between leg s (9.3%; P<0.001) and whole sides (4.8%; P<0.01), There were only minor sid e changes in lean mass. Loss of BMC was independent of weight changes. Conclusions-During the first year after severe stroke, patients developed p ronounced hemiosteoporosis. This was not associated with general changes in lean or fat mass. The development of hemiosteoporosis was independent of w eight changes after stroke.