Increased Bone Resorption During the First Year After Stroke

Background and Purpose—Significant bone mineral density (BMD) reduction occurs in stroke patients on the hemiplegic side compared with the intact side. To elucidate the pathogenesis of hip fractures in this population, we measured serum markers of bone metabolism and BMD in the stroke patients within 1 year (early group) and between 1 and 2 years after onset of hemiplegia (long-term group). Methods—Sera were collected from 51 patients from the early group and 93 patients from the long-term group. All patients had hemiplegia. Sera were assayed for pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker) and bone Gla protein (a bone formation marker). The z score of BMD was determined in both second metacarpals. Results—Serum ICTP concentrations (ng/mL) were higher in the early group (15.4±4.1) than in the long-term group (6.7±4.4). Bone Gla protein was normal or low in both groups. Multiple regression analysis identified Barthel Index, degree of hemiplegia,...