Osteoporosis in haemophilia – an underestimated comorbidity?
- 21 December 2006
- journal article
- Published by Wiley in Haemophilia
- Vol. 13 (1), 79-84
- https://doi.org/10.1111/j.1365-2516.2006.01405.x
Abstract
Summary. A relationship between haemophilia and osteoporosis has been suggested, leading to the initiative for a larger study assessing this issue. Bone mineral density (BMD) was measured by osteodensitometry using dual energy X‐ray absorptiometry (DEXA) in 62 male patients with severe haemophilia A; mean age 41 ± 13.1 years, mean body mass index (BMI) 23.5 ± 3.6 kg m−2. Using the clinical score suggested by the World Federation of Hemophilia, all patients were assessed to determine the severity of their arthropathy. A reduced BMD defined as osteopenia and osteoporosis by World Health Organization criteria was detected in 27/62 (43.5%) and 16/62 (25.8%) patients, respectively. Fifty‐five of sixty‐two (88.7%) patients suffered from haemophilic arthropathy. An increased number of affected joints and/or an increased severity were associated with lower BMD in the neck of femur. Pronounced muscle atrophy and loss of joint movement were also associated with low BMD. Furthermore, hepatitis C, low BMI and age were found to be additional risk factors for reduced BMD in the haemophiliac. Our data shows that in haemophilic patients osteoporosis represents a frequent concomitant observation. The main cause for reduced bone mass in the haemophiliac is most probably the haemophilic arthropathy being typically associated with chronic pain and loss of joint function subsequently leading to inactivity. Further studies including control groups are necessary to elucidate the impact of comorbidities such as hepatitis C or HIV on the development of osteoporosis in the haemophiliac.Keywords
This publication has 24 references indexed in Scilit:
- Orthopaedic assessment in haemophiliaHaemophilia, 2003
- Osteopenia in HIV-infected patients: is it the disease or is it the treatment?AIDS, 2001
- Bone mineral density, serum insulin-like growth factor I, and bone turnover markers in viral cirrhosisHepatology, 1998
- Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric studyBone, 1995
- Alterations in bone turnover in HIV-positive patientsInfection, 1993
- The Significance of Pain in Children's Experiences of HemophiliaClinical Nursing Research, 1993
- Prevalence and prediction of osteopenia in chronic liver diseaseHepatology, 1990
- Infection of human fibroblasts and osteoblast-like cells with HIV-1AIDS, 1990