title: Comparative study of dual energy X-ray absorptiometry and quantitative ultrasonography with the use of biochemical markers of bone turnover in boys with haemophilia.
abstract: Our aim was to evaluate bone status in boys with haemophilia using dual energy X-ray absorptiometry (DXA) and quantitative ultraSonography (QUS), and in addition, to compare these two methods with the use of biochemical markers of bone turnover. Twenty-six boys with a mean decimal age of 12.08 ± 4.44 years were included in the study which included a DXA scan at lumbar spine and radial, as well as tibial QUS. Serum levels of soluble receptor activator of nuclear factor κB ligand (sRANK-L), osteoprotegerin (OPG) and osteocalcin (OC) were measured and joint evaluation was performed using the Hemophilia Joint Health Score (HJHS). With regard to the study results, only 2 of 26 patients (7.7%) had bone mineral density (BMD) Z-scores < -2, and 4 patients (15.4%) had BMD Z-scores between -1 and -2. Only one patient had radial and other two had tibial QUS Z-scores < -2. No agreement was recorded between QUS and DXA in identifying patients at risk for osteoporosis (k = 0.275, P = 0.063). Haemophiliacs had significantly higher serum levels of sRANK-L (21.04 ± 4.78 vs. 18.58 ± 2.28 ng mL(-1), P = 0.038) and of OC (5.35 ± 2.29 vs. 3.09 ± 0.61 ng mL(-1), P = 0.002) and significantly decreased levels of OPG (15.78 ± 2.53 vs. 23.79 ± 4.39 pg mL(-1), P < 0.001) compared with controls. QUS Z-scores at tibia significantly correlated with HJH Scores (r = -0.450, P = 0.040), whereas lumbar BMD Z-scores significantly correlated with body mass index Z-scores (r = 0.500, P = 0.009). More studies are warranted to identify the most accurate densitometric method for assessing bone status in haemophiliacs.
authors.affiliation: 1st Paediatric Department, Aristotle University, Thessaloniki, Greece. christoforidis@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Christoforidis
authors.forename: M
authors.initials: M
authors.lastname: Economou
authors.forename: E
authors.initials: E
authors.lastname: Papadopoulou
authors.forename: E
authors.initials: E
authors.lastname: Kazantzidou
authors.forename: E
authors.initials: E
authors.lastname: Farmaki
authors.forename: V
authors.initials: V
authors.lastname: Tzimouli
authors.forename: I
authors.initials: I
authors.lastname: Tsatra
authors.forename: N
authors.initials: N
authors.lastname: Gompakis
authors.forename: M
authors.initials: M
authors.lastname: Athanassiou-Metaxa
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D006467:Hemophilia A / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D016328:NF-kappa B / Q000097:blood; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000097:blood* / Q000503:physiopathology*; D053244:Osteoprotegerin / Q000097:blood; D053245:RANK Ligand / Q000097:blood; D011884:Radius / Q000000981:diagnostic imaging; D012016:Reference Values; D012307:Risk Factors; D013977:Tibia / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D016328:NF-kappa B; D053244:Osteoprotegerin; D053245:RANK Ligand; D015675:Osteocalcin