VPB0205 - Predictors of body mass index in persons with hemophilia over the life course: multisite, cross-sectional study (n=691)

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

MG

Michael Glenzer, MPH

Statistician
University of California San Diego
San Diego, California, United States

Co-Author(s)

RB

Richard FW Barnes

Statistician
University of California San Diego, Dept of Medicine, San Diego, USA
San Diego, California, United States
Annette von Drygalski, MD

Director, Hemophilia & Thrombosis Treatment Center
University of California San Diego
La Jolla, California, United States

Background: It is assumed that persons with hemophilia (PWH) may be heavier compared to the general population inherent to a less active lifestyle due to bleed-induced arthropathy. In turn, heavy body habitus may contribute to arthropathic progression.

Aims: To examine factors that influence body mass index (BMI) in PWH, and to compare their distribution of BMI to the general male population.

Methods: Cross-sectional data from adult PWH (≥18 years) were extracted from medical records at four Hemophilia Treatment Centers between 2003 and 2014, including BMI, age, race, hemophilia type and severity, and history of Hepatitis C (HCV), human immunodeficiency virus (HIV), and inhibitor status. A matched sample from the general population was derived from a combined dataset of National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2016 (5:1 NHANES:PWH).

Results: 691 PWH were included (median age 39 [IQR 28-52]). PWH demonstrated a leaner distribution of BMI than the general male population (median BMI 26.2 vs 27.3 kg/m2; p < .0001). In PWH, prevalence of HCV infection and coinfection with HCV and HIV (only present ≥age 27) was 63% and 18.4%, respectively. HIV infection alone was rare (n=5). Coinfection was a major contributor to leanness; coinfected PWH were 3-5 kg/m2 lighter than uninfected PWH. HCV infection alone was not a prominent predictor of BMI in PWH, nor was hemophilia type or history of inhibitor. Adjusted BMI among Hispanic PWH was 2-3 kg/m2 higher than among Whites. Prevalence of obesity was higher for moderate severity than for mild or severe hemophilia (36.9% vs 26.2% and 17.5%, respectively).

Conclusion(s): Contrary to prevailing assumptions, adult PWH were leaner than the general male population, in part explained by a high rate of coinfection with HCV and HIV. Improved understanding of PWH-specific weight trends should inform lifestyle interventions to advance hemophilia health outcomes.