Plain Language Summary: People with bleeding disorders such as hemophilia and von Willebrand disease (VWD) may have weaker bones and a higher risk of fractures. While bone health problems are well documented in hemophilia, less is known about bone health in people with VWD.
This study compared bone health in children, adolescents, and adults with hemophilia, VWD, and healthy individuals. Researchers measured bone density, bone strength, and markers of bone growth and breakdown. They also examined how certain blood-clotting and clot-breaking processes might be related to bone health.
The study found that people with VWD had significantly lower bone density than healthy participants. People with hemophilia also tended to have lower bone density, although the difference was not large enough to be considered statistically significant. Both groups had lower bone mineral content, which means they had less mineral in their bones overall.
Researchers also found that higher levels of thrombin, a protein involved in blood clotting, were linked to stronger bones and better bone density. In contrast, higher levels of plasmin, a protein involved in breaking down blood clots, were linked to lower bone density. These blood-related factors appeared to explain bone health differences better than traditional clinical factors or markers of bone turnover.
The findings suggest that both hemophilia and VWD can negatively affect bone health. They also point to a possible connection between the body’s clotting system and bone strength. More research is needed to understand why these relationships exist and whether improving blood-clotting balance could help protect bone health in people with bleeding disorders.
