Reduced bone density among children with severe hemophilia
Reduced bone density among children with severe hemophilia
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DOI：
10.1542/peds.114.2.e177
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发表时间：
2004-08-01
期刊：
影响因子：
8
通讯作者：
Monagle, P
中科院分区：
文献类型：
--
作者：
Barnes, C;Wong, P;Monagle, P
Objective.患有严重血友病的儿童由于负重运动减少和丙型肝炎感染而有骨密度降低的风险。儿童期骨密度降低是晚年骨质疏松症的危险因素。我们在皇家儿童医院对19名患有严重血友病的儿童进行了骨密度横断面调查。结果与下肢关节盲法客观评价结果和丙型肝炎状态相关。患者的平均腰椎骨矿物质表观密度（0.102 g/cm（3））低于对照组（0.113 g/cm（3））。平均区域BMD z评分为-0.92，与对照组相比显著降低。骨密度的差异与体型无关。腰椎BMD z评分与最大单关节评估评分之间存在统计学显著相关性，但基于丙型肝炎状态无差异。我们的研究结果表明，儿童严重血友病骨密度降低。有风险的患者是那些有血友病性关节病体征的患者。由于骨质疏松症可能使血友病患者的未来治疗复杂化，因此建议对年轻患者进行骨密度降低的筛查。
Objective. Children with severe hemophilia are at risk for reduced bone mineral density (BMD) because of reduced weight-bearing exercise and hepatitis C infection. Reduced bone density in childhood is a risk factor for osteoporosis in later life.Study Design. We performed a cross-sectional survey of bone density among 19 children with severe hemophilia, at the Royal Children's Hospital. Results were correlated with findings of blinded objective evaluations of the joints of the lower limb and with hepatitis C status.Results. The mean lumbar bone mineral apparent density for patients was reduced (0.102 g/cm(3)), compared with that for control subjects (0.113 g/cm(3)). The mean areal BMD z score was -0.92, which was significantly reduced, compared with that for control subjects. The difference in bone density was independent of body size. There was a statistically significant relationship between the lumbar BMD z scores and the maximal single joint evaluation scores, but there was no difference based on hepatitis C status.Conclusions. Our results suggest that children with severe hemophilia have reduced BMD. Patients at risk are those with signs of hemophilic arthropathy. Because osteoporosis may complicate the future treatment of patients with hemophilia, screening of young patients for reduced bone density is recommended.