The role of disease severity in influencing body mass index in people with haemophilia: a single‐institutional cross‐sectional study

Abstract

Summary Aim The aim of this study is to evaluate the effect of haemophilia disease severity and potential intermediaries on body mass index (BMI) in patients with hemophilia. Methods A secondary analysis of a cross-sectional study eighty-eight adults with haemophilia was undertaken. Results On bivariate analysis, persons with severe haemophilia had 9.8% lower BMI (95% CI −17.1, −3.0) than persons with non-severe hemophilia. The effect of haemophilia severity on BMI varied significantly by HIV status. Among HIV positive subjects, haemophilia severity was not associated with BMI (+5.0%, 95% CI −22.4, 41.9). Among HIV negative subjects, severe haemophilia was associated with 15.1% lower BMI (95% CI, −23.6, −5.7). Older (>41 years) HIV negative subjects with severe haemophilia had a BMI that was 24.8% lower (95% CI −39.1, −7.0) than those with non-severe haemophilia. No statistically significant association was detected between BMI and severe versus non-severe haemophilia for younger HIV negative subjects. Although joint disease, as measured by the WFH joint score, did not influence the association between haemophilia disease severity and BMI, adjustment for the atrophy component of the WFH score reduced the association between haemophilia severity and BMI by 39.1–69.9%. This suggested that muscle atrophy mediated at least part of the relationship between haemophilia severity and BMI. Conclusion Haemophilia disease severity is associated with BMI and appears to be mediated by muscle atrophy of surrounding joints. This association appears to be possibly modified by HIV status and age.

Hypertension, haematuria and renal functioning in haemophilia – a cross‐sectional study in Europe

“…Even though BMI was a major risk factor, the BMI scores in our sample were significantly lower in severe haemophilia patients than in mild patients. This likely reflects loss of muscle mass in these age cohorts infected with HIV and HCV in the 1980s, as reported [28][29][30][31][32][33][34]. The lower muscle mass may also explain the CrCl values in severe haemophilia.…”

Prevalence and impact of obesity in people with haemophilia: Review of literature and expert discussion around implementing weight management guidelines

“…In PWH, the prevalence of overweight (adults, 19%-59%; children, 15%-21%) and obesity (adults, 18%-36%; children, 17%-22%) is similar to that of the general US population. [20][21][22][23][24][25][26][27][28][29][30][31] Existing evidence suggests minimal correlation between haemophilia severity and risk of obesity, although few studies have evaluated this relationship.…”

Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers

“…Bleeding into joints, muscles and other tissues can cause acute dysfunction and chronic joint damage and disability. [8][9][10][11][12][13][14][15] Data on bleeding tendency in obese PwH are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. 1 Current factor replacement strategies provide improved management of haemophilia compared with prior decades; however, weight status has an important impact on lower extremity joint range of motion and functional disability.…”

“…[2][3][4][5][6][7] In people with haemophilia (PwH), the prevalence of overweight (adults, 19%-59%; children, 15%-21%) and obesity (adults, 18%-36%; children, 17%-22%) is similar to that of the general US population. [8][9][10][11][12][13][14][15] Data on bleeding tendency in obese PwH are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. 3,6,16,17 Limited data exist on the longitudinal impact of obesity and changes of weight, which are mostly derived from case reports.…”