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Multicenter Study
. 2022 Jan-Dec:28:10760296221128294.
doi: 10.1177/10760296221128294.

Prevalence of non-Alcoholic Fatty Liver Disease and Associated Factors in Patients with Moderate or Severe Hemophilia: A Multicenter-Based Study

Ming-Ching Shen  1   2 , Shyh-Shin Chiou  3 , Sheng-Chieh Chou  2 , Te-Fu Weng  4 , Ching-Yeh Lin  1 , Jiaan-Der Wang  5   6 , Shou-Wu Lee  7 , Ching-Tien Peng  8
Affiliations
Multicenter Study

Prevalence of non-Alcoholic Fatty Liver Disease and Associated Factors in Patients with Moderate or Severe Hemophilia: A Multicenter-Based Study

Ming-Ching Shen et al. Clin Appl Thromb Hemost. 2022 Jan-Dec.

Abstract

Introduction: Liver health is essential for persons with hemophilia (PWH) in order to maintain access to new therapies, such as gene therapy. Non-alcoholic fatty liver disease (NAFLD) is seldom reported in the hemophilia population. The study aimed to investigate the prevalence of NAFLD and associated factors in PWH.

Methods: Data of this cross-sectional study were obtained from a multicenter collaborative registry database.

Results: A total of 163 moderate or severe PWH with a complete data of liver examination were analyzed. There were 77 (47.2%) PWH diagnosed with NAFLD. The multivariate analysis showed that overweight/obesity was associated with NAFLD (OR, 4.31, P < .001). In comparison with hemophilia B patients, hemophilia A patients showed a weaker correlation with NAFLD, (OR, 0.30, P = .009). A total of 17 (25.8%) PWH with NAFLD had an elevated level of alanine transaminase (ALT). Both overweight/obesity and presence of inhibitor to clotting factor were independently associated with elevated ALT in PWH with NAFLD.

Conclusions: The study indicated that a high prevalence of NAFLD existed in the hemophilia population. Overweight/obesity was an independent factor for NAFLD and elevated ALT.

Keywords: alanine transaminase; hemophilia; non-alcoholic fatty liver disease; obesity; overweight; prevalence.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study design flowchart. NAFLD, non-alcoholic fatty liver disease; ALT, alanine transaminase.
Figure 2.
Figure 2.
Liver ultrasonography. A 42-Year-old severe hemophilia A with mild fatty liver showing mild increase of liver parenchyma echogenicity compared to kidney (A) and normal visualization of the wall of portal vein(B). A 57-Year-old severe hemophilia B with moderate fatty liver showing moderate increase of liver parenchyma echogenicity compared to kidney (C) and mild dimness of the portal vein wall (D). A 50-Year-old severe hemophilia A with high titer inhibitor and severe fatty liver showing severe increase of liver parenchyma echogenicity compared to kidney (E) and poor visualization of the portal wall due to elevation of echogenicity (F).
See this image and copyright information in PMC

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