Low bone mineral density and associated factors in patients with haemophilia in Colombia.

Abstract

Patients with haemophilia may have lower levels of bone mineral density (BMD) compared with the general population. Moreover, haemophilic patients have increased risk factors for low bone mineral density (LBMD) such as arthropathy and resulting immobility, increasing their risk for osteoporosis and fractures. To assess the prevalence of LBMD and associated risk factors among a group of Colombian haemophilic patients. In this case-control study, 90 patients with haemophilia A and B, over the age of five, were recruited. Controls were healthy participants matched by age, gender, body mass index (BMI), socioeconomic status, and race. All participants underwent dual energy X-ray absorptiometry (DXA) and the Global Physical Activity Questionnaire. Blood tests were collected to evaluate LBMD determinants in cases. BMD was lower in cases than in the control group. BMD of femoral necks was 0.907g/cm2 in cases vs. 1.020g/cm2 in controls (P=.019), and BMD of hips 0.930g/cm2 in cases vs. 1030g/cm2 in controls (P=.019). The greater the severity of haemophilia, the lower BMD in spine, femoral neck, and hips. Elevated C-protein levels were found in 44.1% of patients with LBMD and 14.8% with normal BMD (P=.003). The study found an adjusted prevalence ratio of 2.11, indicating that haemophilic patients are two times more likely to have LBMD (CI95%=1.43-3.11 P<.001). Results from the present study showed that haemophilia was associated with a higher frequency of LBMD. Severity of haemophilia, haemophilic arthropathy, and elevated C-reactive protein levels was directly associated with LBMD.