Prevalence of overweight and obesity in children, adolescents and young adults with severe hemophilia A – results of 3 German pediatric hemophilia treatment centers
M. Olivieri1, C. Königs2, S. Horneff3, C. Bidlingmaier1 (1Munich, Germany, 2Frankfurt, Germany, 3Bonn, Germany)
Bleeding disorders, coagulation and fibrinolytic factors
Date: 17.02.2017,
Time: 17:15 - 18:15
Objective: The prevalence of obesity among children and young adults in Germany is between 10-20%, depending on age. Data on overweight or obese children with hemophilia in Germany are not available. International data suggest that the usual substitution regimes (IU per kg bodyweight) might lead to overdosing. Aim of this study is to investigate the prevalence of overweight and obesity among patients with severe hemophilia A and the influence of body weight on bleeding tendency, factor consumption per year and possible reduction of economic burden of hemophilia therapy by individualized substitution regimes and weight loss programs. We report preliminary data from 3 large pediatric hemophilia treatment centers.
Methods: After obtaining approval of the institutional review board, cross sectional data on height, bodyweight, bleeds/year, factor consumption/year in patients with severe hemophilia A (Factor VIII <1%) were collected. Age dependent body mass index was calculated according to Krohmaier-Hausschild. Yearly factor VIII consumption and the annual bleeding rate were calculated from the patient documents.
Results: We identified 246 patients with severe (F VIII <1%) hemophilia A. Median Age of patients was 14 years, mean 14 years (range 0-30y). Prevalence of overweight among this patients is 18% and 8% were obese. All patients performed regular prophylaxis 2-3.5 times/week. Further analysis respecting yearly factor VIII consumption, bleeding rate and cost reduction by individualized prophylaxis will follow.
Conclusion: Nearly 26% of patients with severe hemophilia A from the three hemophilia centers suffer from overweight or obesity. The rate appears higher compared to the rate of overweight in the general population in Germany. We suppose that the risk factors for the development of obesity are similar. Reduced physical activity due to overprotection by parents may add to the possibly increased prevalence in this cohort. In further data analysis we will concentrate on the following questions: - Is the yearly factor VIII consumption and bleeding tendency influenced by overweight/obesity? - Can factor consumption be reduced by individualized through level adjusted therapy? - Is there a possibility to reduce hemophilia therapy costs in obese patients by reducing body weight? Especially the last point might be helpful in discussions with health insurance to implement weight loss programs.