Prevalence and Predictors of Sarcopenia in Hemophilia: A Comprehensive Cross-sectional Study

BACKGROUND: Sarcopenia, characterized by progressive loss of muscle mass, strength, and function, is a common yet underrecognized complication in individuals with hemophilia, primarily due to recurrent joint and muscle bleeds. It contributes to impaired mobility, reduced quality of life, and long-term disability. Despite its clinical significance, the prevalence of sarcopenia in the hemophilia population remains inadequately understood. AIMS AND OBJECTIVES: To assess the prevalence of sarcopenia among individuals with hemophilia and identify its association with clinical and nutritional risk factors. MATERIALS AND METHODS: A single-center, observational cross-sectional study was conducted at a tertiary care hospital in New Delhi over a 1-year period (November 2023 to October 2024). The study included 35 hemophilia patients aged >12 years. Sarcopenia was assessed based on muscle mass, muscle strength, and the SARC-F questionnaire (Strength, Assistance with Walking, Rise from a Chair, Climb Stairs, and Falls). RESULTS: Sarcopenia was present in 85.7% of patients. It was significantly associated with arthropathy (100%, P = 0.0005), higher annual bleeding rate (ABR >10: 100% vs. 70.6%, P = 0.0453), on-demand therapy (100% vs. 29.4% on prophylaxis, P = 0.0453), lower caloric intake (<2300 kcal/day: 90.9% vs. 0%, P = 0.012), and vitamin D deficiency (<30 ng/mL: 93.1% vs. 50%, P = 0.035). CONCLUSION: Sarcopenia is highly prevalent among patients with hemophilia and is strongly associated with arthropathy, higher bleeding frequency, on-demand therapy, poor nutritional intake, and vitamin D deficiency. Early identification through routine screening and targeted interventions—such as physical rehabilitation, nutritional support, and optimized hemophilia management—are essential to preserve functional independence, reduce disability, and improve long-term outcomes in this population.