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Evaluation of Bone Mineral Density in Children With Hemophilia: An Observational Case-Control Study

A Ashritha1, C G Delhi Kumar1, Jayaprakash Sahoo2

  • 1Departments of Pediatrics.

Journal of Pediatric Hematology/Oncology
|July 24, 2019
PubMed

Insights

Children with hemophilia have lower bone mineral content (BMC), bone mineral density (BMD), and vitamin D levels compared to healthy children. These findings highlight significant bone health issues in pediatric hemophilia patients.

Area of Science:

  • Pediatric Endocrinology
  • Hematology
  • Bone Metabolism

Background:

  • Hemophilia is a genetic bleeding disorder with potential complications affecting bone health.
  • Children with hemophilia may experience impaired bone development and increased fracture risk.

Purpose of the Study:

  • To investigate bone mineral content (BMC), bone mineral density (BMD), vitamin D levels, and bone turnover markers in children with hemophilia.
  • To compare these parameters between children with hemophilia and age-matched healthy controls.

Main Methods:

  • An observational case-control study involving 38 children with hemophilia and 38 healthy controls (ages 2-18).
  • Bone mineral content (BMC) and bone mineral density (BMD) were assessed using dual-energy x-ray absorptiometry.
  • Levels of 25-hydroxyvitamin D [25(OH)D], intact parathormone, osteocalcin, calcium, phosphate, alkaline phosphatase, and urine pyrilinks-D/creatinine ratio were measured.

Main Results:

  • Children with hemophilia exhibited significantly lower BMC and BMD compared to controls (P<0.05).
  • A high prevalence of low BMC (58%) and low BMD (21%) was observed in hemophilic children.
  • The prevalence of vitamin D deficiency (<20 ng/mL) was significantly higher in children with hemophilia (95%) than in controls (65%) (P<0.001).
  • Lower serum phosphorus and higher serum alkaline phosphatase levels were noted in the hemophilia group.

Conclusions:

  • Children with hemophilia demonstrate significantly reduced bone mineral content, bone mineral density, and vitamin D levels.
  • These findings underscore the critical need for monitoring and intervention strategies to address bone health in pediatric hemophilia patients.
Abstract

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