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Bone mineral density in haemophilia patients

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Topic:

Hot topics in Cardiovascular Cell and Pharmacotherapy (Part I)

DOI: http://dx.doi.org/10.1160/TH09-09-0629
Issue: 2010: 103/3 (Mar) pp. 481–681
Pages: 596-603

Bone mineral density in haemophilia patients

A meta-analysis

A. Iorio (1), G. Fabbriciani (2, 3), M. Marcucci (1), M. Brozzetti (4), P. Filipponi (2)

(1) Hemophilia Centre – Internal and Vascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy; (2) U.O. Medicina Generale, Azienda A.S.L. n. 1dell’Umbria – Città di Castello and Umbertide, Italy; (3) Institute of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy; (4) Ospedale di Norcia, Azienda A.S.L. n. 2 dell’Umbria, Perugia, Italy

Summary

Osteoporosis is caused by bone mineral density (BMD) reduction. Haemophilia patients are at increased risk of osteoporosis because of decreased physical activity and blood-borne virus infections. This systematic review of the literature aims at evaluating BMD reduction in severe haemophilia patients and its correlation with patients’ characteristics. Seven case-control studies evaluating lumbar BMD values [g/cm2] (all studies), BMI (5/7 studies), and hepatitis C virus (HCV) seropositivity (6/7 studies) in severe haemophilia patients and controls were meta-analysed. Standardised mean difference (SMD) of BMD was used to compare cases and controls. The effect of body mass index (BMI) and HCV infection was investigated by meta-regression. One hundred one adult cases (age 33 ± 8.9) with 101 controls and 111 paediatric cases (age 8 ± 3.6) with 307 controls were available for analysis. Lumbar BMD was significantly lower in severe haemophilia patients than in controls, both in adult (pooled SMD –1.379, 95% confidence interval [CI] –2.355 to –0.403, p=0.006) and children (pooled SMD –0.438, 95% CI –0.686 to –0.189, p=0.001). The reduction in BMD in patients versus controls was not significantly correlated with the reduction in BMI or with the percentage of HCV-infected patients. This meta-analysis confirms the association between severe haemophilia and low BMD. Future studies should investigate fracture rates and interventions to prevent bone loss in persons with haemophilia

Keywords

Osteoporosis, bone mineral density, Haemophilia, HCV infection

DOI

http://dx.doi.org/10.1160/TH09-09-0629

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