Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia

Abstract

Objective: Increased risk of unfavorable cardiovascular risk factors has been recognised in ageing patients with haemophilia (PwH), but needs further studies in younger patients. The purpose of this study was to assess obesity, hypertension (HT), metabolic variables, insulin resistance and metabolic syndrome in young PwH. Methods: Forty-eight haemophilia A and B patients and 35 age and sex matched healthy controls were included in the study. Anthropometric measurements, blood pressure (BP), fasting glucose and insulin levels, serum lipids and diet were evaluated. The metabolic syndrome was defined according to the criteria of the International Diabetes Federation for pediatric and adult age groups. Results: The mean age of PwH was 21±9 years (range, 6-40 years). Of those ≥18 years, 46% were were obese/overweight while there were no obese/overweight cases in the <18 year-old patients. Obesity was more prevalent in PwH with arthropathy (p=0.017). Seven percent of the PwH between 10 and 18 years-old and 25% of those ≥18 years had metabolic syndrome. There was no difference in metabolic syndrome frequency between PwH and controls >10 years-old (19.5% vs 10% respectively, p=0.34). Fifty percent of the PwH ≥18 years-old had elevated BP or HT. Fasting blood glucose levels of PwH were significantly higher compared to controls (p=0.02). Conclusion: Our study showed that obesity, HT and metabolic syndrome are frequent problems, especially in PwH with arthropathy. Early prevention and management of overweight, obesity and their sequelae must be addressed in clinical practice in order to maximize the overall health of the haemophilia population.

The Role of Physiotherapy in the New Treatment Landscape for Haemophilia

“…Physical activity is important for everybody [33]; but for PWH appropriate activity is particularly important for recovery after musculoskeletal bleeds, and for managing established arthropathy [14]. A lack of physical activity can also be the root cause of many comorbidities, including obesity, cardiovascular disease, and osteoporosis [45,46]. Having a care model whereby the physiotherapist is able to offer education, support and treatment throughout the life course is critical to allaying fears about physical limitations, and encouraging healthy activity at every life stage.…”

Fitness enhances psychosocial well‐being and self‐confidence in young men with hemophilia: Results from Project GYM

“…Life expectancy for people with hemophilia (PWH) has increased because of advances in treatment. Alongside this, there is an emergence of age‐related disorders such as cardiovascular disease, overweight, obesity, and cancer at the same rate as the general population 1‐3 4 and encourages participation in sport 5…”

What COVID-19 can mean for people with hemophilia beyond the infection risk

“…Attention should be paid to symptoms of COVID-19 infection, which can be more pronounced during exercise and could be confused with activity fatigue. These include respiratory symptoms (such as shortness of breath or coughing) and musculoskeletal symptoms (such as muscle aches, fatigue, slowness, acquired weakness, asthenia, and unstable walking), which could be due to nonspecific manifestations caused by COVID-19 [29,30].…”