A high prevalence of non-alcoholic fatty liver disease (NAFLD) exists among patients with hemophilia, according to research published in Clinical and Applied Thrombosis/Hemostasis.

Researchers investigated the prevalence of NAFLD and associated factors in patients with hemophilia using data from a multicenter collaborative registry database. They identified 163 patients (mean age, 33.7 years) with moderate or severe hemophilia for whom complete data of liver examinations was available from regular annual check-ups as part of their comprehensive hemophilia care. Of those, 47.2% were diagnosed with NAFLD.

In a multivariate analysis, the team found that overweight/obesity was associated with NAFLD (odds ratio [OR], 4.31; 95% CI, 1.87-9.93; P <.001). They found that patients with hemophilia A had lower risk of NAFLD relative to those with hemophilia B (OR, 0.30; 95% CI, 0.12-0.75; P =.009).

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Among patients with NAFLD, 25.8% had an elevated level of alanine transaminase (ALT). The investigators found that the presence of inhibitor to clotting factor was associated with elevated ALT in patients with NAFLD (OR, 14.77; 95% CI, 1.52-143.73; P =.004).

“Current therapeutic approaches prolong the life expectancies of [patients with hemophilia], resulting in an elevated demand for liver examination in hemophilia comprehensive care,” concluded the researchers.

Limitations of the study included lack of an age-matched normal population, exclusion of patients with mild hemophilia, use of images from liver ultrasonography instead of histology to diagnose and determine the severity of fatty liver, and the relatively small sample size of patients treated at centers in northern, central, and southern Taiwan.


Shen MC, Chiou SS, Chou SC, et al. Prevalence of non-alcoholic fatty liver disease and associated factors in patients with moderate or severe hemophilia: a multicenter-based study. Clin Appl Thromb Hemost. 2022;28:10760296221128294. doi:10.1177/10760296221128294

This article originally appeared on Hematology Advisor