Osteoporosis severity associated with trace mineral levels in patients with hemophilic arthropathy
MedWire News: The presence and severity of osteoporosis correlates with low levels of serum trace minerals in patients with hemophilia, shows research.
Hemoarthrosis occurs in 75% to 90% of patients with hemophilia, which puts them at an increased risk for reduced bone density in childhood and adolescence, predisposing them to osteoporosis.
Sahar Fathi Ahmed and colleagues from Ain Shams University in Cairo, Egypt, compared 20 patients with hemophilic arthropathy and 20 age- and gender-matched controls, with an overall mean age of 21.7 years.
All patients had their bone mineral density (BMD) assessed using dual-energy X-ray absorptiometry (DXA) at the femoral neck and lumbar spine, and roentgenographic examination of both knee joints. Patients' serum levels of copper, zinc, magnesium, and calcium were measured, and they underwent joint evaluation and a Juvenile Arthritis Functional Assessment Report.
Their results, published in the Journal of Osteoporosis, showed that the patients with hemophilic arthropathy had highly significantly lower z scores for femoral neck and lumbar spine BMD than the controls. BMD correlated negatively with patient joint score and functional assessment score.
They found that serum levels of copper and zinc had a significant positive association with BMD at the femoral neck. However, there was no significant correlation between calcium and magnesium serum levels and the severity of osteoporosis.
"Trace minerals may be important in maintain bone quality through their role as metalloenzymes in the synthesis of collagen and other proteins that form the structure of bone," write the researchers. "They play important functional roles in bone metabolism and bone turnover."
They explain that past research has shown copper is required in cross-linking collagen and elastin in bone, and zinc inhibits osteoclast differentiation and promotes osteoblast activity. Magnesium is thought to also be important for bone cell activity.
The team concludes: "Screening young hemophiliacs for reduced bone density is recommended with measuring the levels of [magnesium], [copper], and [zinc] for better assessment and management of the disease."
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