Anemia is associated with low bone mass in patients with non-alcoholic fatty liver disease

Abstract

Background Nonalcoholic fatty liver disease (NAFLD) is linked to osteoporosis and anemia. Anemia may be also a risk factor of osteoporosis. However, the association between anemia and bone health in patients with NAFLD has not been well clarified. In this study we showed the association between anemia and bone health in patients with NAFLD. Methods A total of 277 subjects (172 women and 105 men) with NAFLD were included in this study. Bone mineral density (BMD) was measured in L1-L3 veterbral body by computed tomography. Cortical thickness (mm) at the L3 veterbral body was also determined. Hemoglobin (Hgb) was determined in an automatic blood cell counter. Anemia was defined based on Hgb level (< 130 g/L in men and < 120 g/L in women). Results The age of patients with anemia was older than that without anemia. Correlation analysis further displayed that BMD was associated with Hb levels (r = 0.21, p < 0.01). The BMD and cortical thickness of men that had anemia was lower than that with normal Hgb (p < 0.05). The prevalence of osteoporosis in men with anemia was higher than that had normal Hgb (28.6% vs 10.7%, p < 0.05). Multivariable analysis showed that anemia was an independent risk factor for osteoporosis in men (OR = 2.94, 95%CI: 1.14–15.60). No association was found between anemia and osteoporosis in women. Conclusion Anemia is associated with risk of osteoporosis in men with NAFLD, but not in women. Treatment of anemia may be helpful for bone health in male patients with NAFLD.