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Low levels of "good" cholesterol make it difficult to recover from stroke

February 23, 2016

The findings are published in the November 27, 2007, issue of Neurology?, the medical journal of the American Academy of Neurology.

???These findings show metabolic stress plays a significant role in stroke recovery,??? said study author George C. Newman, MD, PhD, with Albert Einstein Healthcare Network in Philadelphia, PA, and member of the American Academy of Neurology.

The study involved 3,680 men and women over age 35 in the United States, Canada, and Scotland who had suffered a mild to moderate stroke within the past three months. The participants underwent cognitive and disability tests and were followed for two years.

Researchers found several factors predicted memory and disability problems after stroke: increased age, non-Caucasian race, recurrent stroke, diabetes, stroke in the left hemisphere of the brain, higher levels of homocysteine and lower levels of high-density lipoproteins (HDL), otherwise known as ???good??? cholesterol.

???People with low levels of HDL, high levels of homocysteine, and diabetes are twice as likely as those without such problems to have poorer cognitive function and greater disability after stroke,??? said Newman. ???The study also found stroke recovery was the most difficult for people over the age of 57 with high levels of homocysteine, which is a risk factor for heart problems and associated with low levels of vitamin B6, B12, folic acid and kidney disease.???

Newman says it's unclear why these factors are contributing to a slower stroke recovery and more research is needed. ???We need to focus our attention on identifying and treating these vascular risk factors since they can be modified.???

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???When we corrected for the amount of muscle, we found that the obese person is not making as much bone as they should be for the amount of muscle that they have,??? Pollock said. ???People haven't observed that in the past because they weren't using the three-dimensional scan.???

Lewis said the exact mechanisms by which excess fat hinders bone strength are unclear, but studies of obese rats show that they produce more fat cells in the bone marrow and fewer bone cells. Since fat and bone cells originate from the same precursor, it may be that fat cell production is favored over bone cell production in obese people.

The women the researchers studied were 18 and 19, an age at which the bones have stopped growing but before age-related degeneration begins. Lewis said future studies using three-dimensional bone imaging should follow children with normal and high levels of body fat through time to see how their skeletons grow. Other researchers have documented increased fractures in overweight children, suggesting that childhood obesity may be particularly detrimental to bone health.

???When you're young you have the capacity to change the shape of your bones, but when you get older you don't have that capacity.??? Lewis said. ???And because of that, childhood obesity could have a significant, long lasting negative impact on the skeleton.???

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