Role of the Parathyroid Gland on Bone Mass and Metabolism in Immobilized Stroke Patients.

概要

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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' Zscores 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.
久留米大学医学部 The Kurume Medical Journal 編集部の論文