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Serum Sclerostin Level and Bone Mineral Density in Pediatric Hemophilic Arthropathy

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Abstract

Objective

To assess serum sclerostin levels in relation to severity of arthropathy and bone mineral density (BMD) in children with hemophilic arthropathy.

Methods

This cross-sectional study included 40 male children suffering from Hemophilia A, and 10 matched healthy controls. Assessment of factor VIII deficiency degree, frequency of bleeding, type of treatment, body mass index (BMI), disease severity using the Hemophilia Joint Health Score (HJHS) and lumbar spine (LS) Z score for bone mineral density (BMD) using dual-energy X-ray absorbiometry was done. Serum sclerostin levels were measured for all patients and controls.

Results

Significant difference of serum sclerostin levels between the patient and control groups with Mean ± SD (0.09 ± 0.07 ng/ml) and (0.04 ± 0.01 ng/ml) (P value = 0.028) respectively was found. Significant positive correlations between serum sclerostin levels and the patients’ age, and HJHS (P value <0.05) were found, while it had negative correlation with DEXA Z score, not reaching a significant value. LS-BMD-Z score levels ranged from (−4.5 to 1.2), with 15 patients with low BMD Z score (less than −2) representing 37.5% of total patients.

Conclusions

Serum sclerostin levels are elevated in hemophilic children denoting bone metabolism affection and correlates with increased age, and HJHS. Increased levels of serum sclerostin may identify hemophilic patients at high risk for developing osteoporosis.

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Authors and Affiliations

  1. Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Dalia M. E. El-Mikkawy & Mohja A. Elbadawy

  2. Department of Pediatrics, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Shereen M. Abd El-Ghany

  3. Department of Clinical Pathology, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Dalia Samaha

Authors
  1. Dalia M. E. El-Mikkawy
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  2. Mohja A. Elbadawy
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  3. Shereen M. Abd El-Ghany
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  4. Dalia Samaha
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Contributions

DME El-M: Collection of patients from clinic, clinical assessment and HJHS assessment, prepare patients data for statistical analysis; MAE: Helped in clinical data assessment and writing the manuscript; SMA El-G: Collection of blood samples; DS: Laboratory analysis of serum sclerostin levels. DME El- M will act as guarantor for this paper.

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Correspondence to Dalia M. E. El-Mikkawy.

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El-Mikkawy, D.M.E., Elbadawy, M.A., Abd El-Ghany, S.M. et al. Serum Sclerostin Level and Bone Mineral Density in Pediatric Hemophilic Arthropathy. Indian J Pediatr 86, 515–519 (2019). https://doi.org/10.1007/s12098-019-02855-1

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  • DOI: https://doi.org/10.1007/s12098-019-02855-1

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