Joint Problems May Be Good Indicator of Low Bone Density and Osteoporosis
Physical function assessment can be a good predictor of lower bone mineral density and osteoporosis development associated with hemophilia, according to a report published in the American Journal of Blood Research.
Therapies to treat hemophilia made available in the past decades have significantly improved patients’ outcomes. This extended survival has brought to light some complications associated with the disease that have gone unrecognized until now. One of these comorbidities is the loss of bone mineral density and natural structure, known by the medical term osteoporosis.
Osteoporosis is characterized by increased bone fragility and risk of fracture, mainly due to the lack of supportive bone structure. Several environmental factors are known to contribute to the development of this condition including excessive alcohol intake and smoking. But it also can be due to chronic diseases and unbalanced hormone levels.
People with hemophilia often are physically inactive due to joint problems. In addition, this patient population often has vitamin D deficiency, and increased prevalence of HCV/HIV infections. All these factors may contribute to loss of bone density and developing osteoporosis.
In the study “Evaluation of bone mineral density and related parameters in patients with haemophilia: a single center cross-sectional study” a research team at Ege University Hospital, in Turkey, assessed the prevalence of low bone mineral density and its association with potential clinical predictive factors in 49 patients with moderate-to-severe hemophilia.
They found that 34.8 percent of the patients under the age of 50 had lower bone mineral density than expected for their age, and 66.6 percent of the patients older than 50 had osteoporosis.
“This study confirmed that patients with hemophilia have an increased prevalence of low BMD [bone mineral density] even in young patient group of less than 50 years of age,” the researchers wrote.
The team did not find any association between smoking habits and viral infections with low bone density in this group of patients. Although vitamin D deficiency was found to be very common among these patients (77.5 percent), it was not found to be a contributing factor for their lower bone mineral density.
Determination of musculoskeletal functions via functional independence score in hemophilia (FISH) and hemophilia joint health score (HJHS) revealed that worse physical scores was significantly associated with lower bone density.
Based on these results the researchers believe that “joint disability due to hemophilic arthropathy [joint disease] seems to be the most important predisposing factor for low BMD [bone mineral density].”
“We suggest that FISH score and HJHS might be used as the simple predictors of BMD by reflecting the severity of hemophilic arthropathy in adult patients,” they added.