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Thromb Haemost 2010; 103(03): 596-603
DOI: 10.1160/TH09-09-0629
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Bone mineral density in haemophilia patients

A meta-analysis
Alfonso Iorio
1   Hemophilia Centre – Internal and Vascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy
,
Gianluigi Fabbriciani
2   U.O. Medicina Generale, Azienda A.S.L. n. 1 dell’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
,
Maura Marcucci
1   Hemophilia Centre – Internal and Vascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy
,
Matteo Brozzetti
4   Ospedale di Norcia, Azienda A.S.L. n. 2 dell’Umbria, Perugia, Italy
,
Paolo Filipponi
2   U.O. Medicina Generale, Azienda A.S.L. n. 1 dell’Umbria – Città di Castello and Umbertide, Italy
› Author Affiliations
Further Information

Publication History

Received: 07 September 2009

Accepted after minor revision: 12 January 2009

Publication Date:
22 November 2017 (online)

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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

Bone mineral density - osteoporosis - haemophilia - HCV infection
 

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