Prevalence and risk factors associated with decreased bone mineral density in patients with haemophilia
Abstract
Summary. 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 41.5 years (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.
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Mice and patients with hemophilia due to lack of clotting factor VIII or IX are osteoporotic and osteopenic.
“It is also known that mice (and patients) with hemophilia due to lack of clotting factor VIII or IX are osteoporotic and osteopenic (36, 38).”
From Targeting myostatin/activin A protects against skeletal muscle and bone loss during spaceflight (2020) · cites this paper as [38]
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Targeting myostatin/activin A protects against skeletal muscle and bone loss during spaceflight
Lee, S.-J., Lehar, A., Meir, J. U., Koch, C., Morgan, A., Warren, L. E., Rydzik, R., Youngstrom, D. W., Chandok, H., George, J., et al. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2014716117 · Cited by 115 · see citing works
“It is also known that mice (and patients) with hemophilia due to lack of clotting factor VIII or IX are osteoporotic and osteopenic (36, 38).”
Taves, S., Sun, J., Livingston, E. W., Chen, X., Amiaud, J., Brion, R., Hannah, W. B., Bateman, T. A., Heymann, D., & Monahan, P. E. (2019) · Scientific Reports · doi:10.1038/s41598-019-50787-9 · Cited by 26 · see citing works
- Authors
- GERSTNER, G., DAMIANO, M. L., TOM, A., WORMAN, C., SCHULTZ, W., RECHT, M., & STOPECK, A. T.
- Affiliations
- University of Arizona Cancer Center (US)
- Phoenix Children's Hospital (US)
- Oregon Health & Science University (US)
- Corresponding author
- STOPECK, A. T.
- Venue
- Haemophilia
- Publisher
- Wiley
- Published
- 2009-03
- Volume
- 15
- Issue
- 2
- Pages
- 559-565
- ISSN
- 1351-8216 (ISSN-L)
- 1365-2516
- OpenAlex
- W2138731249
- Cited by
- 148
- References
- 38
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 9 · 2023: 5 · 2022: 12 · 2021: 9 · 2020: 14 · 2019: 8 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 12 · 2013: 13 · 2012: 11
- FWCI
- 5.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Haemophilia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Hemophilia Treatment and Research
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- osteoporosis, bone loss risk factors, vitamin D insufficiency, 25-hydroxyvitamin D, body mass index, physical activity, range of motion, HIV infection, hepatitis C, osteopenia, fracture prevention
- MeSH terms
- Adolescent, Adult, Aged, Blood Coagulation Factors, Hemophilia B, Female, Hemophilia A, Humans, Male, Middle Aged, Osteoporosis, Radionuclide Imaging, Risk Factors, Vitamin D Deficiency, Absorptiometry, Photon, Bone Density, Prevalence, Young Adult
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