OSTEOPOROSIS AND SARCOPENIA IN HAEMOPHILICS WHO UNDERWENT ORTHOPEDIC MAJOR SURGERY: AN OBSERVATIONAL STUDY CONCLUSIONS Both young and older PWH who underwent orthopedic surgery showed very high prevalence of sarcopenia and vitamin D deficiency. Low BMD occurs in adults with haemophilia more frequently than in general popula@on. Further studies are required to examine more in depth this topic. REFERENCES: •Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in Older People; A.J. Cruz-Jentoft et al.: Age an Ageing 2010; 39: 412-423 •The Nonskeletal Effects of Vitamin D: An Endocrine Society Scientific Statement; Rosen J, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, Murad MH, and Kovacs CS. Clifford Endocrine Reviews, June 2012, 33(3):456–492 •Orthopedic co-morbidities in the elderly haemophilia population: a review; D. Stephensen and EC Rodriguez-Merchan; Haemophilia (2013), 19, 166-173 •Bone Health in persons with haemophilia; CL Kempton, DM Antoniucci, EC Rodriguez-Merchan; Haemophilia (2015), 21, 568-577 Rossella Tosini 1 ; Marco Martinelli 1 ; Walter Passeri 1 ; Vincenzo Gatteri 1 ; Stefania Pivetti 1 ; Luisa Cigolini 1 ; Sonia Chiari 1 ; Andrea Zenorini 1 ; Elena Santagostino 2 ; Luigi Solimeno 3; Luciano Bissolotti 1 1 Rehabilitation Center “Domus Salutis”, Teresa Camplani Foundation Brescia, Italy; 2 UOS Emofilia, IRCCS Cà Granda Foundation, Milan, Italy; 3 UOS Ortopedia, IRCCS Cà Granda Foundation, Milan, Italy INTRODUCTION AND OBJECTIVE A decreased or impaired mobility is the most frequently suggested mechanism for the lower bone mineral density (BMD) in pa=ents with haemophilia (PWH). According to the physiology of the musclebone development, limited physical ac=vity leads to sarcopenia, that in turn increases the risk to develop osteopenia/osteoporosis. In this study we aimed to determine the prevalence of osteoporosis/osteopenia and sarcopenia in PWH. RESULTS • According to World Health Organiza1on criteria to define osteoporosis, we divided pa=ents in two groups: below the age of 50 years (median age 38 ys, Body Mass Index 24,07 Kg/ m2) and over the age of 50 years (median age 58 ys, Body Mass Index 24,1 Kg/m2). • Among pa>ents < 50 ys, 14.8% had osteoporosis (Z < 2), 40.7% presented osteopenia (2 < Z score < 1). 88% had vitamin D below 30 ng/dl and 20% showed severe vitamin D deficiency. On the basis of European consensus on defini=on of Sarcopenia, according to SMI cut off, 83.3% had mild moderate sarcopenia and 16.7% severe sarcopenia; 22.2% showed low handgrip strength (<30 kg). MATERIALS AND METHODS We included adults (n = 54) with haemophilia A or B hospitalized in Rehabilita=on Unit aaer orthopedic major surgery (total knee, ankle and hip replacement; osteosynthesis and leg amputa=on). Lumbar and femoral dualenergy Xray absorp=ometry (DXA) was performed to analyze BMD. Skeletal muscle mass was es=mated by bioelectrical impedance analysis (BIA 101 Akern) and skeletal mass index (SMI) was calculated with Bodygram PLUS soaware to classify sarcopenia (n = 34). Handgrip strength was evaluated with Jamar dynamometer (n =34). Vitamin D deficiency was also inves=gated (n = 50). Sarcopenia in haemophilics groups 44.5% 40.7% 14.8% Osteoporosis and osteopenia; < 50 ys 83.3 50 16.7 50 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% < 50 ys > 50 ys 12 88 20 0 20 40 60 80 100 > 30 ng/mL < 30 ng/mL < 10 ng/mL 25OHD; < 50 ys % 9.5 90.5 38.1 0 20 40 60 80 100 > 30 ng/mL < 30 ng/mL < 10 ng/mL 25OHD; > 50 ys % 22.2% 59.3% 18.5% Osteoporosis and osteopenia; > 50 ys T score > 1 • Among pa>ents > 50 ys, 18.5% had osteoporosis (T < 2.5) and 59.3% osteopenia (2.5 < T score < 1). 90.5% showed vitamin D below 30 ng/dl and 38.1% had severe vitamin D deficiency. 50% presented mildmoderate sarcopenia and 50% severe sarcopenia; 73.3% exhibited low handgrip strength. 2 < Z score < 1 Z score > 1 T score < 2.5 2.5 < Tscore < 1 severe mild-moderate Z score < 2