title: Inactivity is a risk factor for low bone mineral density among haemophilic children.
abstract: Reduced bone mineral density (BMD) in childhood is a risk factor for osteoporosis in later life. This case-control study determined the prevalence of low BMD, calcium intake and physical activity in 62 haemophilic children and 62 sex-, race- and age-matched healthy boys as controls. Lumbar spine (L2-L4) BMD was determined by dual-energy X-ray absorptiometry; BMD was considered to be low when Z-score > or =2. Physical activity was assessed using a validated questionnaire and calcium intake with a standardized quantitative food frequency questionnaire. Twenty-four patients (38%) had low BMD, whereas this was found in only 10 (16%) controls [odds ratio (OR) 2.86, 95% confidence interval (CI) 1.17-7.41; P = 0.014]. Lumbar BMD was significantly lower in the haemophilia patients than the controls (-1.6 +/- 1.0 vs. -0.9 +/- 0.9 respectively; P = 0.0004). Sedentary and low-grade exercise predominated in haemophilia (77%) versus control (50%) (OR 3.2, 95% CI 1.36-7.79; P = 0.003). There were no differences between groups with regard to calcium intake. Our results suggest that low-physical activity is a risk factor for reduced lumbar bone mass in the haemophilic group. This factor must be monitored to avoid a significant reduction in BMD that might contribute to further skeletal fragility.
authors.affiliation: Medical Research Division, UMAE Hospital de Pediatria, Centro Medico Nacional de Occidente IMSS, Guadalajara, Mexico. albtlacuilo@yahoo.com
authors.forename: Alberto
authors.initials: A
authors.lastname: Tlacuilo-Parra
authors.forename: Ramses
authors.initials: R
authors.lastname: Morales-Zambrano
authors.forename: Nadia
authors.initials: N
authors.lastname: Tostado-Rabago
authors.forename: Maria Amparo
authors.initials: MA
authors.lastname: Esparza-Flores
authors.forename: Beatriz
authors.initials: B
authors.lastname: Lopez-Guido
authors.forename: Javier
authors.initials: J
authors.lastname: Orozco-Alcala
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D015519:Bone Density; D002136:Calcium, Dietary / Q000008:administration & dosage; D016022:Case-Control Studies; D002648:Child; D006467:Hemophilia A / Q000503:physiopathology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D009043:Motor Activity; D010024:Osteoporosis / Q000209:etiology; D012307:Risk Factors
chemical_list: D002136:Calcium, Dietary