scholarly journals Bone mineral density in Canadian children with severe haemophilia A or B: a cross-sectional study

2021 ◽  
Vol 8 (1) ◽  
pp. 111-118
Author(s):  
Cecily Bos ◽  
Paul Tieu ◽  
John K Wu ◽  
Karen Strike ◽  
Anthony KC Chan

Abstract Background Previous research has shown that bone mineral density (BMD), a measure of bone strength, may be lower among people with haemophilia. However, the majority of this research has been done in adults and in countries where the treatment for haemophilia differs from the standard of care in Canada, and there is a lack of paediatric data. Aims The primary objective of this study was to determine whether Canadian children and youth with severe haemophilia A and B have BMD similar to healthy controls matched for height, age and weight (HAW-score). Secondary objectives included the exploration of any association between BMD and the following variables: factor replacement regimen, Hemophilia Joint Health Score (HJHS), bleeding history, physical activity level, and dietary intake of calcium, vitamin D, vitamin K and protein. Methods A cross-sectional observational study was designed to determine the BMD of children with severe haemophilia A and B in Canada. Ethical approvals were obtained from participating institutions. Thirty-eight participants aged 3–18 with severe haemophilia A and B were recruited from two treatment centres in Canada. Subjects underwent dual-energy X-ray absorptiometry (DXA) scan, and data was collected from regular clinic visit to identify factor replacement regimen, HJHS, and number of joint bleeds over the lifespan. Physical activity level and dietary intake of calcium, vitamin D, vitamin K and protein were identified using self-report questionnaires. Results Participants showed a mean spine BMD Z-score and HAW-score higher than controls, with no participants showing a spine Z-score or HAW-score of <0. Hip BMD score was within normal range, and 2 participants had a Z-score and HAW-score of <−2. Total body BMD score was lower than controls, with 6 participants having a Z-score of <−2.0, and 3 participants having a HAW-score of <−2.0. Factor replacement regimen, HJHS, calcium intake, and physical activity level had no relationship to BMD Z-score or HAW-score. Low intake of vitamin D was associated with a low hip and spine BMD Z-score and HAW-score. Participants with a HJHS joint score greater than 0 had a higher total body HAW-score than those who had a joint score of 0. Conclusion Canadian children with severe haemophilia A and B demonstrate differences in spine and total body BMD from height-, age-, and weight-matched controls, where spine BMD is higher than controls and total body BMD is lower than controls. Studies with a larger sample size are needed to clarify the status of BMD in children with haemophilia treated with primary prophylaxis.

Author(s):  
Glauber Dallanezi ◽  
Beatriz Freire ◽  
Eliana Nahás ◽  
Jorge Nahás-Neto ◽  
José Corrente ◽  
...  

2014 ◽  
Vol 58 (5) ◽  
pp. 572-582 ◽  
Author(s):  
Marília Brasilio Rodrigues Camargo ◽  
llda Sizue Kunii ◽  
Lilian Fukusima Hayashi ◽  
Patrícia Muszkat ◽  
Catherine Gusman Anelli ◽  
...  

Objectives To evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian osteoporotic patients and the modifiable factors of vitamin D status in this population. Subjects and methods In a cross-sectional study, 363 community-dwelling patients who sought specialized medical care were evaluated between autumn and spring in São Paulo, Brazil. Serum levels of 25(OH)D and parathormone (PTH), biochemical and anthropometric measurements, and bone density scans were obtained. The group was assessed using two questionnaires: one questionnaire covered lifestyle and dietary habits, skin phototype, sun exposure, medical conditions, and levels of vitamin D supplementation (cholecalciferol); the other questionnaire assessed health-related quality-of-life. Logistic regression and a decision tree were used to assess the association between the variables and the adequacy of vitamin D status. Results The mean age of the overall sample was 67.9 ± 8.6 years, and the mean 25(OH)D concentration was 24.8 ng/mL. The prevalence of inadequate vitamin D status was high (73.3%), although 81.5% of the subjects were receiving cholecalciferol (mean dose of 8,169 IU/week). 25(OH)D was positively correlated with femoral neck bone mineral density and negatively correlated with PTH. In the multivariate analysis, the dose of cholecalciferol, engagement in physical activity and the month of the year (September) were associated with improvement in vitamin D status. Conclusions In this osteoporotic population, vitamin D supplementation of 7,000 IU/week is not enough to reach the desired 25(OH)D concentration (≥ 30 ng/mL). Engagement in physical activity and the month of the year are modifiable factors of the vitamin D status in this population.


2021 ◽  
Vol 49 (1, 2, 3) ◽  
pp. 23
Author(s):  
Admir Mehičević ◽  
Nevena Mahmutbegović ◽  
Ibrahim Omerhodžić ◽  
Enra Mehmedika Suljić

<p><strong>Objective. </strong>The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients.</p><p><strong>Patients and Methods. </strong>A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method.</p><p><strong>Results</strong>. There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±}12.86 vs. Vitamin D LTG 17.97±}9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±}10.87 vs. OCLN LTG 27.87±}28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08±} 1.38 vs. T-score LTG: 0.37±} 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±}1.17 vs. Z. Score CBZ: 0.38±}0.96; F=4.069, P=0.046) (Table 3).</p><strong>Conclusion</strong>. The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.


2013 ◽  
Vol 17 (10) ◽  
pp. 2287-2294 ◽  
Author(s):  
Alynne Christian Ribeiro Andaki ◽  
Adelson Luiz Araújo Tinôco ◽  
Edmar Lacerda Mendes ◽  
Roberto Andaki Júnior ◽  
Andrew P Hills ◽  
...  

AbstractObjectiveTo evaluate the effectiveness of anthropometric measures and physical activity level in the prediction of metabolic syndrome (MetS) in children.DesignCross-sectional study with children from public and private schools. Children underwent an anthropometric assessment, blood pressure measurement and biochemical evaluation of serum for determination of TAG, HDL-cholesterol and glucose. Physical activity level was calculated and number of steps per day obtained using a pedometer for seven consecutive days.SettingViçosa, south-eastern Brazil.SubjectsBoys and girls (n 187), mean age 9·90 (sd 0·7) years.ResultsConicity index, sum of four skinfolds, physical activity level and number of steps per day were accurate in predicting MetS in boys. Anthropometric indicators were accurate in predicting MetS for girls, specifically BMI, waist circumference measured at the narrowest point and at the level of the umbilicus, four skinfold thickness measures evaluated separately, the sum of subscapular and triceps skinfold thickness, the sum of four skinfolds and body fat percentage.ConclusionsThe sum of four skinfolds was the most accurate method in predicting MetS in both genders.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Leandro Alberto Calazans Nogueira ◽  
Luciano Teixeira dos Santos ◽  
Pollyane Galinari Sabino ◽  
Regina Maria Papais Alvarenga ◽  
Luiz Claudio Santos Thuler

Objective. The purpose of this study was to analyze factors related to lower walking speed in persons with multiple sclerosis (PwMS).Methods. A cross-sectional survey was conducted. The study participants were 120 consecutive PwMS, who were able to walk, even with device assistance. Demographic and clinical data were collected. Walking speed was measured in 10 m walk test. Possible factors were assessed: disability, fatigue, visual functioning, balance confidence, physical activity level, walking impact, cognitive interference, and motor planning. A forward linear multiple regression analysis examined the correlation with lower speed.Results. Lower walking speed was observed in 85% of the patients. Fatigue (41%), recurrent falls (30%), and balance problems were also present, even with mild disability (averageEDSS=2.68). A good level of physical activity was noted in most of the subjects. Dual-task procedure revealed 11.58% of walking speed reduction. Many participants (69.57%) imagined greater walking speed than motor execution (mean ≥ 28.42%). Physical activity level was the only characteristic that demonstrated no significant difference between the groups (lower versus normal walking speed). Many mobility measures were correlated with walking speed; however, disability, balance confidence, and motor planning were the most significant.Conclusions. Disability, balance confidence, and motor planning were correlated with lower walking speed.


Author(s):  
Dorthe Dalstrup Jakobsen ◽  
Jasper Schipperijn ◽  
Jens Meldgaard Bruun

Background: In Denmark, most children are not sufficiently physically active and only a few interventions have been found to increase long-term physical activity among overweight and obese children. The aim of our study was to investigate if children are physically active in correspondence to Danish recommendations after attending a multicomponent-overnight camp. Methods: A questionnaire was developed to estimate children’s physical activity level and behavior and investigate how transport, economy, availability, time, motivation, and knowledge about physical activity affect children’s physical activity level and behavior. Results: In this study, 60.9% of the children did vigorous physical activity (VPA) minimum 30 minutes 3 times per week up to 3 years after camp. Most children were physically active at a sports club (44.3%) and only 5.7% of the children did not participate in physical activity. Parental physical activity and child motivation toward physical activity were significantly (P < .05) associated with children doing VPA. Conclusion: Our findings suggest that 60.9% of children who attended camp engage in VPA after camp, which compared with a recent Danish study, is more frequent than children who did not attend camp. Further investigations are needed to determine the long-term health effects in children attending interventions such as multicomponent-overnight camps.


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