Prevalence and risk factors associated with decreased bone mineral density in patients with haemophilia

G. Gerstner, M. L. Damiano, A. Tom, C. Worman, W. Schultz, Michael Recht, Alison T. Stopeck

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Osteoporosis in adult males is an under-recognized problem. Patients with haemophilia have several predisposing factors for developing decreased bone mineral density (BMD) including prolonged periods of immobility, reduced weight bearing and co-morbidities associated with bone loss. To establish prevalence and risk factors associated with decreased BMD in patients with haemophilia. Adults with moderate or severe haemophilia A or B underwent dual-energy X-ray absorptiometry (DXA). BMD was correlated to laboratory values, joint mobility measurements and physical activity questionnaires. Thirty patients completed evaluations. The median age was 41.5years (range 18-61). Median lowest T-score by DXA was -1.7 (range: -5.8 to +0.6), with the femoral neck being the site of the lowest T-scores. Based on World Health Organization criteria, 70% of patients had decreased BMD. Twenty-seven per cent of the participants (n = 8) had osteoporosis and 43% (n = 13) had osteopenia. Variables associated with increased bone loss included lower serum 25-hydroxyvitamin D levels (P = 0.03), lower body mass index (P = 0.047), lower activity scores (P = 0.02), decreased joint range of motion (P = 0.046), HIV (P = 0.03), HCV (P = 0.02), history of inhibitor (P = 0.01) and age (P = 0.03). Adults with haemophilia are at increased risk for developing osteoporosis. A history of HCV and HIV infections, decreased joint range-of-motion, decreased activity levels, history of an inhibitor and low body weight predict bone loss and suggest a population to target for screening. A high prevalence of vitamin D insufficiency was observed. Future studies should investigate interventions, including vitamin D supplementation, to prevent bone loss and fractures for this at-risk population.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalHaemophilia
Volume15
Issue number2
DOIs
StatePublished - 2009

Fingerprint

Hemophilia A
Bone Density
Osteoporosis
Photon Absorptiometry
Articular Range of Motion
Bone and Bones
Vitamin D
Hemophilia B
Metabolic Bone Diseases
Health Services Needs and Demand
Femur Neck
Bone Fractures
Weight-Bearing
Causality
HIV Infections
Body Mass Index
Joints
Body Weight
HIV
Exercise

Keywords

  • Bone mineral density
  • Haemophilia
  • Osteoporosis

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

Cite this

Prevalence and risk factors associated with decreased bone mineral density in patients with haemophilia. / Gerstner, G.; Damiano, M. L.; Tom, A.; Worman, C.; Schultz, W.; Recht, Michael; Stopeck, Alison T.

In: Haemophilia, Vol. 15, No. 2, 2009, p. 559-565.

Research output: Contribution to journalArticle

Gerstner, G. ; Damiano, M. L. ; Tom, A. ; Worman, C. ; Schultz, W. ; Recht, Michael ; Stopeck, Alison T. / Prevalence and risk factors associated with decreased bone mineral density in patients with haemophilia. In: Haemophilia. 2009 ; Vol. 15, No. 2. pp. 559-565.
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