{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:43:59Z","timestamp":1788669839268,"version":"build-2803163510"},"reference-count":0,"publisher":"Pensoft Publishers","issue":"1","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Osteopenia and osteoporosis are well-known hemophilia A comorbidities. The pathogenesis of bone turnover alteration resulting in reduced bone mass includes impaired osteoblastic differentiation and disinhibition of RANKL-induced osteoclastogenesis as a result of a low FVIII level.<\/jats:p>\n          <jats:p><jats:bold>Aim:<\/jats:bold> To evaluate the bone mineral density (BMD) in adult patients with severe hemophilia A and assess a possible correlation with the bone remodeling biomarkers OPG\/RANKL, CTX-1, osteocalcin, and Vit D.<\/jats:p>\n          <jats:p><jats:bold>Materials and methods:<\/jats:bold> 28 male subjects with severe hemophilia A and 33 age-matched controls were recruited. The biomarkers were tested with the ELISA assay and BMD with DEXA of the lumbar spine (LS) and total hip (TH).<\/jats:p>\n          <jats:p><jats:bold>Results:<\/jats:bold> The patients had lower LS-BMD (&amp;minus;0.955&amp;plusmn;0.145 vs. 1.118&amp;plusmn;0.079, p=0.05) and TH-BMD (&amp;minus;0.840&amp;plusmn;0.147 vs. 0.951&amp;plusmn;0.075, p=0.05) than those of the controls. The TH T-scores were &amp;minus;1.41&amp;plusmn;0.91 vs. 0.4&amp;plusmn;0.49 (p=0.05) and the LS T-scores &amp;minus;1.16&amp;plusmn;1.046 vs. 0.14&amp;plusmn;0.72 (p=0.05). 66.6% of patients under 50 years had osteopenia and 8.3% had osteoporosis. Fifty percent of those over 50 years old had osteopenia and 20% had osteoporosis. We found significantly higher OPG levels (123.69&amp;plusmn;107.05 vs. 41.98&amp;plusmn;18.95, p=0.05) than that in controls and lower sRANKL levels (23.49&amp;plusmn;29.39 vs. 131.32&amp;plusmn;201.27, p=0.05) and sRANKL\/OPG ratio (0.27&amp;plusmn;0.35 vs. 5.28&amp;plusmn;10.01, p=0.05) than those in controls. A positive correlation was found between sRANKL and the BMD T-score of lumbar spine (p=0.001) in the patient group.<\/jats:p>\n          <jats:p><jats:bold>Conclusions:<\/jats:bold> sRANKL level and ratio can be used as predictors of low BMD.<\/jats:p>","DOI":"10.3897\/folmed.65.e75414","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T16:32:18Z","timestamp":1677601938000},"page":"87-92","source":"Crossref","is-referenced-by-count":4,"title":["A single-center study of bone mineral density in adult patients with severe hemophilia A in correlation with markers of bone metabolism"],"prefix":"10.3897","volume":"65","author":[{"given":"Hristina A.","family":"Ivanova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanet","family":"Grudeva-Popova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0089-4230","authenticated-orcid":true,"given":"Tanya","family":"Deneva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Tsvetkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonka","family":"Mateva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2023,2,28]]},"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/75414\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/75414\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/75414\/download\/pdf\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T16:32:20Z","timestamp":1677601940000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/75414\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,2,28]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.65.e75414","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2023,2,28]]}}}