Changes in fat mass in stroke survivors: a systematic review

Authors

  • Coralie English,

    Corresponding author
    • International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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  • Kerry Thoirs,

    1. International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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  • Alison Coates,

    1. Nutritional Physiology Research Centre, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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  • Alice Ryan,

    1. Baltimore Veterans Affairs Research Service, Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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  • Julie Bernhardt

    1. Stroke Division, Florey Neuroscience Institutes, Melbourne, Victoria, Australia
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  • Conflict of interest: None declared.
  • Funding: Dr English is supported by a National Health and Medical Research Council Research Training Fellowship (#610312). Dr Ryan was supported by a VA Research Career Scientist Award, National Institute on Aging grants RO1-AG030075, and Claude D. Pepper Older Americans Independence Center P30-AG028747.

Correspondence: Coralie English*, School of Health Sciences, University of South Australia, PO Box 2471, Adelaide, SA 5001. Australia.

E-mail: coralie.english@unisa.edu.au

Abstract

Background

Stroke survivors have less muscle mass in their paretic limbs compared with nonparetic limbs, which may or may not be accompanied by changes in regional and/or whole body fat mass.

Aim

To examine the current evidence regarding differences in regional fat mass between paretic and nonparetic limbs and changes in whole body fat mass over time in stroke survivors.

Methods

A systematic search of relevant databases. Studies measuring whole body or regional fat mass using dual-energy X-ray absorpiometry, computed tomography, or magnetic resonance imaging were included.

Results

Eleven trials were identified. Fat mass differences between paretic and nonparetic limbs and change in fat mass over time were not consistent. Meta-analyses were conducted using dual-energy X-ray absorpiometry-derived data from 10 trials (n = 324). There were no differences in fat mass between paretic and nonparetic legs (pooled mean difference 31·4 g, 95% confidence interval −33·9 to 96·6, P = 0·35), and slightly greater fat mass in the paretic arms compared with nonparetic arms (pooled mean difference 84·0 g, 95% confidence interval 30·7 to 137·3, P = 0·002). Whole body fat mass did not increase significantly between one-month and six-months poststroke (pooled mean difference 282·3 g, 95% confidence interval −824·4 to 1389, P = 0·62), but there was an increase between six- and 12 months poststroke (pooled mean difference 1935 g, 95% confidence interval 1031 to 2839, P < 0·001).

Conclusions

There were inconsistent findings regarding changes in fat mass after stroke. Large, well-designed studies are required to further investigate the impact of body composition changes on the health of stroke survivors.

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