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

74 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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