January 9, 2019

Risk factors in children and young people with haemophilia

Concern about the possible risk of age-related disorders among people with haemophilia has been tempered by some evidence that many do not appear to be at greater risk than the population without bleeding disorders. Recent evidence from Turkey suggests some young people with haemophilia have cardiovascular risk factors – but no more than other people (J Clin Res Pediatr Endocrinol 2018 Dec 24. doi: 10.4274/jcrpe.0292).

The prevalence of cardiovascular risk factors in 48 children, young people and young adults with haemophilia A and B (mean age 21, range 6 – 40) was compared with that in 35 healthy controls matched for age and sex. Mean BMI was similar (24 – 25 kg/m2) and about 17% in each group exercised regularly. About 60% of the over-18s with haemophilia had arthropathy.

The prevalence of obesity/overweight was 46% in those with haemophilia aged 18 or older but zero among the under-18s and higher among those with arthropathy. There were no significant differences between patients and controls in the prevalence of obesity/overweight, raised blood pressure, dyslipidaemia or insulin resistance, though fasting glucose was raised in significantly more people with haemophilia (29% vs 9% of controls).

These findings suggest that the long term complications of haemophilia are themselves a risk factor for cardiovascular risk factors. In other respects, people with haemophilia may be no better or worse off than anyone else.