Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia

Mehmet Dagli; Ali Kutlucan; Sedat Abusoglu; Abdulkadir Basturk; Mehmet Sozen; Leyla Kutlucan; Ali Unlu; Farise Yilmaz

doi:10.17305/bjbms.2018.2335

Authors

Mehmet Dagli Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
Ali Kutlucan Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
Sedat Abusoglu Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey
Abdulkadir Basturk Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
Mehmet Sozen Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
Leyla Kutlucan Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey
Ali Unlu Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey
Farise Yilmaz Department of Nuclear Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

DOI:

https://doi.org/10.17305/bjbms.2018.2335

Keywords:

Hemophilia, osteoporosis, bone mineral density, BMD, procollagen type I N-terminal propeptide, PINP, urinary N-terminal telopeptide, uNTX, complete blood count, CBC, bone resorption, bone formation

Abstract

A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.

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Author Biographies

Mehmet Dagli, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Internal Medicine
Ali Kutlucan, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Internal Medicine
Sedat Abusoglu, Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Biochemistry
Abdulkadir Basturk, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Internal Medicine
Mehmet Sozen, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Internal Medicine
Leyla Kutlucan, Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey

Department of Anesthesiology
Ali Unlu, Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Biochemistry
Farise Yilmaz, Department of Nuclear Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

Department of Nuclear Medicine

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