{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T08:12:23Z","timestamp":1773216743196,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In people with haemophilia (PWH), recurrent episodes of bleeding lead to joint deterioration and bone resorption. To date, the effects of various other factors on bone mineral density (BMD) reduction have found conflicting results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to analyse the relationships between BMD, bone mineral content (BMC), and trabecular bone score (TBS) parameters based on the dual X\u2010ray absorptiometry method (DXA) and potential risk factors for osteoporosis in patients with severe haemophilia A.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010five men with severe haemophilia A, aged 18\u201368 years, and 59 healthy volunteer men were enrolled in this study. Densitometric\u2010derived lumbar spine and femoral neck BMD, BMC, and TBS were measured. Blood analyses were performed for morphology parameters, liver and kidney function parameters, and viral status. Serum levels of oestradiol (E<jats:sub>2<\/jats:sub>), testosterone (T), dehydroepiandrosterone sulphate (DHEA\u2010S), parathormone, and vitamin D were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients showed significantly lower BMD compared to controls (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.003). The result below the expected range for age was nearly double (6.82%\u00a0vs. 3.92%) in PWH under 50 years old compared to controls. Haemophilic patients also exhibited significantly higher vitamin D3 deficiency (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001), which was strongly associated with low TBS. Additionally, low body mass index and high neutrophil\/lymphocyte ratio were correlated with low BMC and BMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study confirms the prevalence of low BMD and BMC in patients with haemophilia in Poland. Factors that contribute to low BMD are primarily vitamin D deficiency, low BMI, high neutrophil\/lymphocyte ratio, and low testosterone\/oestradiol ratio.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14903","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T20:19:22Z","timestamp":1702412362000},"page":"130-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of bone mineral density and potential risk factors for osteoporosis in patients with severe haemophilia A"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-3398","authenticated-orcid":false,"given":"Monika Maria","family":"Biernat","sequence":"first","affiliation":[{"name":"Department and Clinic of Hematology Blood Neoplasms, and Bone Marrow Transplantation Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"J\u0119drzejuk","sequence":"additional","affiliation":[{"name":"Department and Clinic of Endocrinology Diabetology, and Isotope Therapy Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donata","family":"Urbaniak\u2010Kujda","sequence":"additional","affiliation":[{"name":"Department and Clinic of Hematology Blood Neoplasms, and Bone Marrow Transplantation Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Biernat","sequence":"additional","affiliation":[{"name":"Chair and Department of Drug Forms Technology Wroclaw Medical University  Wroc\u0142aw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Laszkowska\u2010Lewko","sequence":"additional","affiliation":[{"name":"Department and Clinic of Hematology Blood Neoplasms, and Bone Marrow Transplantation Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Landw\u00f3jtowicz","sequence":"additional","affiliation":[{"name":"Department and Clinic of Endocrinology Diabetology, and Isotope Therapy Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewelina","family":"Majdak","sequence":"additional","affiliation":[{"name":"Department and Clinic of Endocrinology Diabetology, and Isotope Therapy Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Podolak\u2010Dawidziak","sequence":"additional","affiliation":[{"name":"Department and Clinic of Hematology Blood Neoplasms, and Bone Marrow Transplantation Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"Department and Clinic of Hematology Blood Neoplasms, and Bone Marrow Transplantation Wroclaw Medical University  Wroclaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.200099"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.achaem.2016.04.009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2021.100852"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21103538"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.794456"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-020-06052-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1718890"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2015.06.013"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12240"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01963.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222413640"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22042105"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/s1980\u2010220\u00d72018039903572"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-017-0410-z"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2015.05.016"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12690"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00012-2"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2019.01.006"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.2255"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14046"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02616.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-014-2773-7"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14540"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.17305\/bjbms.2018.2335"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2007.12.003"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH11-08-05563"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2013.02.005"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.975400"},{"key":"e_1_2_10_31_1","first-page":"59","article-title":"Evaluation of bone mineral density and related parameters in patients with haemophilia: a single center cross\u2010sectional study","volume":"7","author":"Kiper Unal HD","year":"2017","journal-title":"Am J Blood Res"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13611"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.31744\/einstein_journal\/2020AO4694"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnab015"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00033.2015"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-018-0826-z"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.93.BJR-2019-0141.R1"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab459"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.14903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T13:08:54Z","timestamp":1712322534000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.14903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/hae.14903"],"URL":"https:\/\/doi.org\/10.1111\/hae.14903","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]},"assertion":[{"value":"2023-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}