Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK.
Pediatric/Adult Comprehensive Hemostasis Center, CHU Sainte-Justine/Sainte-Justine University Hospital Center, Montréal, Québec, Canada.
Obes Rev. 2018 Nov;19(11):1569-1584. doi: 10.1111/obr.12746. Epub 2018 Sep 6.
Overweight and obesity may carry a significant disease burden for patients with haemophilia (PWH), who experience reduced mobility due to joint inflammation, muscle dysfunction and haemophilic arthropathy. This review aimed to define the prevalence and clinical impact of overweight/obesity in the global population of PWH. A detailed literature search pertaining to overweight/obesity in haemophilia in the last 15 years (2003-2018) was conducted, followed by a meta-analysis of epidemiological data. The estimated pooled prevalence of overweight/obesity in European and North American PWH was 31%. Excess weight in PWH is associated with a decreased range in motion of joints, accelerated loss of joint mobility and increase in chronic pain. Additionally, the cumulative disease burden of obesity and haemophilia may impact the requirement for joint surgery, occurrence of perioperative complications and the prevalence of anxiety and depression that associates with chronic illness. Best practice guidelines for obesity prevention and weight management, based on multidisciplinary expert perspectives, are considered for adult and paediatric PWH. Recommendations in the haemophilia context emphasize the importance of patient education and tailoring engagement in physical activity to avoid the risk of traumatic bleeding.
超重和肥胖可能会给血友病患者（PWH）带来巨大的疾病负担，因为他们会因关节炎症、肌肉功能障碍和血友病性关节炎而导致活动能力下降。本综述旨在确定全球 PWH 人群中超重/肥胖的流行程度和临床影响。对过去 15 年（2003-2018 年）有关血友病中超重/肥胖的文献进行了详细的检索，随后对流行病学数据进行了荟萃分析。欧洲和北美的 PWH 中估计超重/肥胖的总体患病率为 31%。PWH 体重超标与关节活动范围减小、关节活动度丧失加速和慢性疼痛增加有关。此外，肥胖和血友病的累积疾病负担可能会影响关节手术的需求、围手术期并发症的发生以及与慢性疾病相关的焦虑和抑郁的发生率。针对成人和儿科 PWH，基于多学科专家意见，制定了肥胖预防和体重管理的最佳实践指南。血友病背景下的建议强调了患者教育的重要性，并根据个人情况调整身体活动的参与度，以避免创伤性出血的风险。
