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Amelioration of osteoporosis and hypovitaminosis D by sunlight exposure in stroke patients

From the Departments of Rehabilitation Medicine (Drs. Sato and Metoki) and Vascular Biology (Dr. Satoh), Institute of Brain Science, Hirosaki University School of Medicine; Department of Neurology (Dr. Sato), Futase Social Insurance Hospital, Iizuka; and Department of Sport Medicine (Dr. Iwamoto), Keio University School of Medicine, Tokyo, Japan.

Address correspondence and reprint requests to Dr. Y. Sato, Department of Neurology, Mitate Hospital, 3237 Yugeta, Tagawa 826-0041, Japan; e-mail: y-sato{at}ktarn.or.jp

Background: The authors’ previous investigations have disclosed low serum 25-hydroxyvitamin D (25-OHD) concentrations in 45 patients during long-term hospitalization following stroke (mean 5.9 ng/mL). This 25-OHD deficiency resulted from sunlight deprivation.

Objective: To evaluate the efficacy of sunlight exposure in increasing serum 25-OHD, in reducing the severity of osteoporosis in bone mineral density (BMD), and in decreasing the risk of hip fractures in chronically hospitalized, disabled stroke patients.

Methods: In a 12-month randomized and prospective study of stroke patients, 129 received regular sunlight exposure for 12 months, and the remaining 129 (sunlight-deprived) did not.

Results: At baseline, patients of both groups showed vitamin D deficiency. BMD increased by 3.1% in the sunlight-exposed group and decreased by 3.3% in the sunlight-deprived group (p = 0.0001). 25-OHD level increased by fourfold in the sunlight-exposed group. Six patients sustained hip fractures on the hemiplegic side in the sunlight-deprived group, and one hip fracture occurred among the sunlight-exposed group (p = 0421; odds ratio = 6.1).

Conclusion: Sunlight exposure can increase the BMD of vitamin D-deficient bone by increasing 25-OHD concentration.

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