Yıl: 2019 Cilt: 11 Sayı: 2 Sayfa Aralığı: 173 - 180 Metin Dili: İngilizce DOI: 10.4274/jcrpe.galenos.2018.2018.0292 İndeks Tarihi: 28-04-2020

Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia

Öz:
Objective: Increased risk of unfavorable cardiovascular risk factors has been recognised in ageing patients with haemophilia (PwH), butneeds further studies in younger patients. The purpose of this study was to assess obesity, hypertension (HT), metabolic variables, insulinresistance and metabolic syndrome in young PwH.Methods: Forty-eight haemophilia A and B patients and 35 age and sex matched healthy controls were included in the study.Anthropometric measurements, blood pressure (BP), fasting glucose and insulin levels, serum lipids and diet were evaluated. Themetabolic syndrome was defined according to the criteria of the International Diabetes Federation for pediatric and adult age groups.Results: The mean age of PwH was 21±9 years (range, 6-40 years). Of those ≥18 years, 46% were were obese/overweight while therewere no obese/overweight cases in the <18 year-old patients. Obesity was more prevalent in PwH with arthropathy (p=0.017). Sevenpercent of the PwH between 10 and 18 years-old and 25% of those ≥18 years had metabolic syndrome. There was no differencein metabolic syndrome frequency between PwH and controls >10 years-old (19.5% vs 10% respectively, p=0.34). Fifty percent ofthe PwH ≥18 years-old had elevated BP or HT. Fasting blood glucose levels of PwH were significantly higher compared to controls(p=0.02).Conclusion: Our study showed that obesity, HT and metabolic syndrome are frequent problems, especially in PwH with arthropathy.Early prevention and management of overweight, obesity and their sequelae must be addressed in clinical practice in order to maximizethe overall health of the haemophilia population.
Anahtar Kelime:

Konular: Endokrinoloji ve Metabolizma Pediatri
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Biere-Rafi S, Baarslag MA, Peters M, Kruip MJ, Kraaijenhagen RA, Den Heijer M, Büller HR, Kamphuisen PW. Cardiovascular risk assessment in haemophilia patients. Thromb Haemost 2011;105:274-278. Epub 2010 Dec 6
  • 2. Sun H, Yang M, Fung M, Chan S, Jawi M, Anderson T, Poon MC, Jackson S. Adult males with haemophilia have a different macrovascular and microvascular endothelial function profile compared with healthy controls. Haemophilia 2017;23:777-783. Epub 2017 Jun 16
  • 3. Rosendaal FR, Varekamp I, Smit C, Brocker-Vriends AH, van Dijck H, Vandenbroucke JP, Hermans J, Suurmeijer TP, Briët E. Mortality and causes of death in Dutch haemophiliacs, 1973-86. Br J Haematol 1989;71:71-76.
  • 4. Darby SC, Kan SW, Spooner RJ, Giangrande PL, Hill FG, Hay CR, e Lee CA, Ludlam CA, Williams M. Mortality rates, life expectancy, and causes of death in people with hemophilia A or B in the United Kingdom who were not infected with HIV. Blood 2007;110:815-825. Epub 2007 Apr 19
  • 5. Biere-Rafi S, Tuinenburg A, Haak BW, Peters M, Huijgen R, De Groot E, Verhamme P, Peerlinck K, Visseren FL, Kruip MJ, Laros-Van Gorkom BA, Gerdes VE, Buller HR, Schutgens RE, Kamphuisen PW. Factor VIII deficiency does not protect against atherosclerosis. J Thromb Haemost 2012;10:30-37.
  • 6. Limjoco J, Thornburg CD. Risk factors for cardiovascular disease in children and young adults with haemophilia. Haemophilia 2018;24:747-754. Epub 2018 Jul 13
  • 7. Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N Engl J Med 2015;373:1307-1317.
  • 8. Roosendaal G, Lafeber FP. Pathogenesis of haemophilic arthropathy. Haemophilia 2006;12(Suppl 3):117-121.
  • 9. Kahan S, Cuker A, Kushner RF, Maahs J, Recht M, Wadden T, Willis T, Majumdar S, Ungar D, Cooper D. Prevalence and impact of obesity in people with haemophilia: Review of literature and expert discussion around implementing weight management guidelines. Haemophilia 2017;23:812-820. Epub 2017 Jun 21
  • 10. von Drygalski A, Kolaitis NA, Bettencourt R, Bergstrom J, KruseJarres R, Quon DV, Wassel C, Li MC, Waalen J, Elias DJ, Mosnier LO, Allison M. Prevalence and risk factors for hypertension in hemophilia. Hypertension 2013;62:209-215. Epub 2013 Apr 29
  • 11. Alperstein W, Corrales-Medina FF, Tamariz L, Palacio AM, Davis JA. Prevalence of Hypertension (HTN) and Cardiovascular Risk Factors in a Hospitalized Pediatric Hemophilia Population. J Pediatr Hematol Oncol 2018;40:196-199.
  • 12. White GC, Rosendaal F, Aledort LM, Lusher JM, Rothschild C, Ingerslev J; Factor VIII and Factor IX Subcommittee. Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis. Thromb Haemost 2001;85:560.
  • 13. Turkey Dietary Guidelines. Ankara: Ministry of Turkey Health; 2016. Available from: https://dosyasb.saglik.gov.tr/ Eklenti/10922,17ocaktuberingilizcepdf.pdf?0
  • 14. Trumbo P, Schlicker S, Yates AA, Poos M; Food and Nutrition Board of the Institute of Medicine, The National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc 2002;102:1621-1630.
  • 15. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatr 2006;95:194- 198.
  • 16. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-163.
  • 17. Hickman TB, Briefel RR, Carroll MD, Rifkind BM, Cleeman JI, Maurer KR, Johnson CL. Distributions and trends of serum lipid levels among United States children and adolescents ages 4-19 years: data from the Third National Health and Nutrition Examination Survey. Prev Med 1998;27:879-890.
  • 18. Flynn JT, Falkner BE. New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents. Hypertension 2017;70:683-686. Epub 2017 Aug 21
  • 19. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/ NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71:1269-1324. Epub 2017 Nov 13
  • 20. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419.
  • 21. Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G, Alberiche M, Bonadonna RC, Muggeo M. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. Diabetes 1998;47:1643-1649.
  • 22. Shashaj B, Luciano R, Contoli B, Morino GS, Spreghini MR, Rustico C, Sforza RW, Dallapiccola B, Manco M. Reference ranges of HOMAIR in normal-weight and obese young Caucasians. Acta Diabetol 2016;53:251-260. Epub 2015 Jun 13
  • 23. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S; IDF Consensus Group. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes 2007;8:299-306.
  • 24. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005;365:1415-1428.
  • 25. Sousos N, Gavriilaki E, Vakalopoulou S, Garipidou V. Understanding cardiovascular risk in hemophilia: A step towards prevention and management. Thromb Res 2016;140:14-21. Epub 2016 Feb 2
  • 26. Pocoski J, Ma A, Kessler CM, Boklage S, Humphries TJ. Cardiovascular comorbidities are increased in U.S. patients with haemophilia A: a retrospective database analysis. Haemophilia 2014;20:472-478. Epub 2013 Nov 29
  • 27. Wang JD, Chan WC, Fu YC, Tong KM, Chang ST, Hwang WL, Lin CH, Tsan YT. Prevalence and risk factors of atherothrombotic events among 1054 hemophilia patients: a population-based analysis. Thromb Res 2015;135:502-507. Epub 2015 Jan 10
  • 28. Wilding J, Zourikian N, Di Minno M, Khair K, Marquardt N, Benson G, Ozelo M, Hermans C. Obesity in the global haemophilia population: prevalence, implications and expert opinions for weight management. Obes Rev 2018;19:1569-1584. Epub 2018 Sep 6
  • 29. Biere-Rafi S, Haak BW, Peters M, Gerdes VE, Büller HR, Kamphuisen PW. The impairment in daily life of obese haemophiliacs. Haemophilia 2011;17:204-208.
  • 30. Sharathkumar AA, Soucie JM, Trawinski B, Greist A, Shapiro AD. Prevalence and risk factors of cardiovascular disease (CVD) events among patients with haemophilia: experience of a single haemophilia treatment centre in the United States (US). Haemophilia 2011;17:597- 604. Epub 2011 Feb 15
  • 31. Rosendaal FR, Briet E, Stibbe J, van Herpen G, Leuven JA, Hofman A, Vandenbroucke JP. Haemophilia protects against ischaemic heart disease: a study of risk factors. Br J Haematol 1990;75:525-530.
  • 32. Funston MR, Levine E, Stables DP. Spontaneous renal hemorrhage. Urology 1976;8:610-617.
  • 33. Bereket A, Atay Z. Current status of childhood obesity and its associated morbidities in Turkey. J Clin Res Pediatr Endocrinol 2012;4:1-7.
  • 34. Gündogan K, Bayram F, Capak M, Tanriverdi F, Karaman A, Ozturk A, Altunbas H, Gökce C, Kalkan A, Yazici C. Prevalence of metabolic syndrome in the Mediterranean region of Turkey: evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia. Metab Syndr Relat Disord 2009;7:427-434.
APA Yildiz M, Özdemir N, Onal H, Koc B, ELİUZ TİPİCİ B, Zulfikar B (2019). Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. , 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
Chicago Yildiz Melek,Özdemir Nihal,Onal Hasan,Koc Basak,ELİUZ TİPİCİ BEYZA,Zulfikar Bulent Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. (2019): 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
MLA Yildiz Melek,Özdemir Nihal,Onal Hasan,Koc Basak,ELİUZ TİPİCİ BEYZA,Zulfikar Bulent Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. , 2019, ss.173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
AMA Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. . 2019; 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
Vancouver Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. . 2019; 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
IEEE Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B "Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia." , ss.173 - 180, 2019. 10.4274/jcrpe.galenos.2018.2018.0292
ISNAD Yildiz, Melek vd. "Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia". (2019), 173-180. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0292
APA Yildiz M, Özdemir N, Onal H, Koc B, ELİUZ TİPİCİ B, Zulfikar B (2019). Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology, 11(2), 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
Chicago Yildiz Melek,Özdemir Nihal,Onal Hasan,Koc Basak,ELİUZ TİPİCİ BEYZA,Zulfikar Bulent Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology 11, no.2 (2019): 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
MLA Yildiz Melek,Özdemir Nihal,Onal Hasan,Koc Basak,ELİUZ TİPİCİ BEYZA,Zulfikar Bulent Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology, vol.11, no.2, 2019, ss.173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
AMA Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology. 2019; 11(2): 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
Vancouver Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology. 2019; 11(2): 173 - 180. 10.4274/jcrpe.galenos.2018.2018.0292
IEEE Yildiz M,Özdemir N,Onal H,Koc B,ELİUZ TİPİCİ B,Zulfikar B "Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia." Journal of Clinical Research in Pediatric Endocrinology, 11, ss.173 - 180, 2019. 10.4274/jcrpe.galenos.2018.2018.0292
ISNAD Yildiz, Melek vd. "Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia". Journal of Clinical Research in Pediatric Endocrinology 11/2 (2019), 173-180. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0292