Presentation Details
| Vitamin D Deficiency in Persons with Bleeding Disorders – a single center experience Dan Leary, Mindy Simpson, Lisa Boggio. Rush Hemophilia and Thrombophilia Center, Chicago, IL, USA |
Abstract
Introduction: Vitamin D is a common, treatable vitamin deficiency in the United States. Overall, 15% of the pediatric population and 35% of the adult population has Vitamin D deficiency. No studies have described Vitamin D deficiency in Persons with Bleeding Disorders (PWBD: Hemophilia A (HA), Hemophilia B (HB), and Von Willebrand Disease (VWD)) in Chicago. Objective: To determine the status of Vitamin D Deficiency in PWBD at our center and to evaluate the association with type of bleeding disorder, age, race, and prescription for vitamin D supplementation. Patients and Methods: After IRB approval, we performed a descriptive, cross-sectional study including 254 patients ages 1 to 76 years from Rush Hemophilia and Thrombophilia Center. Data were obtained on type of bleeding disorder, Age, Race, Vitamin D Supplementation prescription, and Vitamin D levels from 11/23/2010 - 3/2/2023. ANOVA analysis was performed. Vitamin D deficiency was defined as: Severe: <10 ng/mL, Moderate: 10-<20 ng/mL, Insufficient: 20-30 ng/mL, and Normal: >30 ng/mL. Results: Patient mean age was 26.5 ± 16.4 years; 199 (78.3%) were male. Our population was 165 Caucasian (64.9%), 49 Black or African American (19.3%), 7 Asian (2.8%), 1 Hawaiian/Alaskan Native (0.4%) and 33 Other/Unknown (13.0%). 145 (57.1%) had HA, 27 (10.6%) had HB, 62 (24.4%) had VWD. A prescription for Vitamin D was given to 176 (69.7%) patients – all of those who were not Normal. Mean 25(OH)D level was 25.5±12.4 ng/mL among all bleeding disorders; 21 (8.30%) had severe deficiency, 78 (30.83%) moderate, 77 (30.43%) insufficient, and 78 (30.43%) were normal. In those with moderate and severe deficiency, 57 (65.5%) had HA, 6 (6.9%) HB, and 24 (27.6%) VWD. There was not an association between age or race and vitamin D status (p = 0.745). There was also no difference between type of bleeding disorder and vitamin D deficiency (p = 0.214). Conclusions: The majority of our bleeding disorder patients (69.6%) have low vitamin D levels. An association with race, age, and prescription for Vitamin D was not demonstrated in deficient patients. As our bleeding disorder patients are at significantly increased risk of developing osteoporosis and osteopenia due to hemophilic arthropathy made worse by vitamin D deficiency, we suggest providers screen all bleeding disorder patients for Vitamin D Deficiency, treat with supplementation if needed, and monitor Vitamin D Serum titers throughout their care. Further evaluation of Vitamin D status is needed in this population.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.