Usefulness of bone microarchitectural and geometric DXA-derived parameters in haemophilic patients

Autor:	Elena Santagostino, Giulia Angela Antonella Rebagliati, Maria Rosaria Fasulo, Luca Petruccio Piodi, Luigi Piero Solimeno, Gianluigi Pasta, Elena Anna Boccalandro, Maria Elisa Mancuso, Fabio Massimo Ulivieri
Rok vydání:	2018
Předmět:	Adult Male musculoskeletal diseases Arthrodesis medicine.medical_treatment Osteoporosis Population Dentistry 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Hemophilia A Bone and Bones 03 medical and health sciences Absorptiometry Photon 0302 clinical medicine Trabecular bone score Bone Density Risk Factors Arthropathy medicine Humans Femur education Genetics (clinical) Dual-energy X-ray absorptiometry Aged Retrospective Studies Bone mineral education.field_of_study medicine.diagnostic_test business.industry Hematology General Medicine Middle Aged musculoskeletal system medicine.disease Female business
Zdroj:	Haemophilia. 24:980-987
ISSN:	1351-8216
Popis:	Introduction Haemophilia is a recessive X-linked inherited bleeding disorder, whose typical symptom is spontaneous intra-articular haemorrhage leading to joint damage, which can be quantified by the Haemophilia Joint Health Score (HJHS). Arthropathy and other characteristics of haemophilic patients may reduce bone mineral density (BMD), increasing the risk for fragility fractures, which also may occur due to bone quality impairment. Aim To evaluate bone quantity by BMD and bone quality by Trabecular Bone Score (TBS), bone strain (BS) and hip structural analysis (HSA) in a haemophilic population, and to relate these parameters to general and specific risk factors for osteoporosis and to HJHS. Methods Seventy haemophilic patients ≥18 years were enrolled. Densitometric derived lumbar spine and femoral BMD with TBS, BS and HSA were performed. Data regarding risk factors for osteoporosis, presence of arthroprosthesis or arthrodesis were collected, and HJHS was calculated. A Z-score ≤-2.0 defined a low bone mass. Results Overall, a reduced bone mass was present in 52 patients at the femur and in 38 at the lumbar spine. Lumbar spine BMD, TBS and BS did not correlate with HJHS. HSA bone geometric parameters correlated negatively with HJHS. BMD and HSA correlated with some risk factors for osteoporosis, namely HIV and its therapy, hepatitis C and smoking. Conclusions Haemophilic patients showed a reduced BMD at lumbar spine and/or femur. Femoral bone density and geometry correlated with HJHS. The microarchitecture of the trabecular vertebral bone seemed to be not influenced by the haemophilic joint damage.
Databáze:	OpenAIRE
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