Association of Metabolic Dysfunction-Associated Fatty Liver Disease and Liver Stiffness With Bone Mineral Density in American Adults

Li, Hejun; Luo, Hengcong; Zhang, Ying; Liu, Lisi; Lin, Rong

doi:10.3389/fendo.2022.891382

Cited by 10 publications

(11 citation statements)

References 56 publications

(62 reference statements)

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“…And this result had a lower OR for reduced bone mineral density in women with NAFLD than in controls (0.52; 95% CI 0.30–0.88; P = 0.016). The findings of this paper are consistent with the results of many previous studies that have used DXA to determine BMD at selected study sites to explore the relationship between BMD and NAFLD [ 13 , 17 , 27 ]. However, in some studies using the same research approach, the opposite conclusion was reached that there is a negative correlation between NAFLD and BMD [ 12 , 28 ].…”

Section: Discussionsupporting

confidence: 89%

“…However, the findings drawn from the investigation of this relationship are not identical. In the general US population, NAFLD and liver fibrosis are not associated with decreased femoral bone mineral density, according to Stefano Ciardullo [ 16 ], and in Hejun Li, it was stated that metabolic-associated fatty liver disease and liver stiffness were associated with higher femoral and lumbar spine BMD in individuals aged 50 and older [ 17 ]. NAFLD, however, was linked in a Korean study to risk variables for men's femoral neck bone density and protective factors for women's lumbar spine bone density [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between nonalcoholic fatty liver disease and bone mineral density in elderly Chinese

Zhang,

Zhao,

Wang

et al. 2023

J Orthop Surg Res

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Objective As our society grows older, both bone loss and fatty liver have become important issues. However, the relationship between reduced bone mineral density and fatty liver remains controversial. The purpose of this study was to investigate the relationship between nonalcoholic fatty liver disease and less bone mineral density in the ankles of Chinese people over 65. Methods The research included 716 older adults over the age of 65 who underwent a comprehensive health screening. A logistic regression model was used to investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and ankle bone mineral density. Results A logistic regression model was used to analyze the odds ratios of reduced bone mineral density between patients with fatty liver and controls. In the adjusted model, adjustments were made for age, sex, systolic blood pressure, diastolic blood pressure, overweight rate, history of hypertension, history of diabetes, history of smoking, history of alcohol consumption, fasting glucose, hemoglobin, urea, creatinine, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, waist circumference, total protein, albumin, and globulin. The adjusted OR (aOR) for reduced bone mineral density was 0.66 [95% confidence interval (CI) = 0.45–0.97, P = 0.034 < 0.05]. In subgroup analysis by age, sex, and BMI, women, age > 75 years, and BIM < 25 were statistically significant. Conclusion This study suggested that NAFLD is associated with a reduced risk of reduced heel bone mass. More research needs to be done to back up the results of this study and look into possible problems.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Relationship between nonalcoholic fatty liver disease and bone mineral density in elderly Chinese

Zhang,

Zhao,

Wang

et al. 2023

J Orthop Surg Res

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“…performed a cross-sectional study in 2,031 participants over 50 years old in NHANES 2017–2018 and found the positive association of MAFLD with BMD as well as the negative association of MAFLD with femoral osteoporosis. However, the association of MAFLD with osteoporosis became insignificant when BMI was adjusted as a potential confounding factor ( 18 ). Liu et al.…”

Section: Discussionmentioning

confidence: 99%

“…found that liver fibrosis was independently associated with lower BMD and elevated risk of osteopenia and osteoporosis in NAFLD subjects ( 32 ). Li used data from NHANES 2017–2018 and found a positive association between liver stiffness and BMD as well as a negative association of liver fibrosis with femoral osteoporosis, but all these associations became statistically non-significant after adjusting for BMI and other confounding factors ( 18 ). Similarly, Ciardullo et al.…”

Section: Discussionmentioning

confidence: 99%

Associations of metabolic dysfunction-associated fatty liver disease and hepatic fibrosis with bone mineral density and risk of osteopenia/osteoporosis in T2DM patients

Zhang,

Li,

et al. 2023

Front. Endocrinol.

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BackgroundExisting evidence on the associations of liver steatosis and fibrosis with bone mineral density (BMD) and risk of osteopenia/osteoporosis was limited with conflicting results. We aimed to evaluate the associations of metabolic dysfunction-associated fatty liver disease (MAFLD) and hepatic fibrosis with BMD and risk of osteopenia/osteoporosis in type 2 diabetes mellitus (T2DM) patients.MethodsBaseline information of an ongoing cohort of 249 T2DM patients in Xiamen, China was analyzed. MAFLD was defined as the presence of hepatic steatosis [diagnosed by either hepatic ultrasonography scanning or fatty liver index (FLI) score >60] for T2DM patients. BMD was measured using dual-energy x-ray absorptiometry at total lumbar (L2–4), femur neck (FN), and total hip (TH) and was categorized as normal (T ≥ −1.0), osteopenia (−2.5 < T < −1.0), or osteoporosis (T ≤ −2.5) according to its minimum T-score.ResultsAmong the 249 T2DM patients, prevalence rates of MAFLD, osteopenia, and osteoporosis were 57.8%, 50.6%, and 17.7%, respectively. Patients with MAFLD had significantly higher BMD T-scores of L2–4, FN, and TH and the minimum as well as lower prevalence of osteoporosis than patients without MAFLD. Hepatic steatosis indices, including FLI score, fatty liver (FLI ≥ 60 or hepatic ultrasonography scanning), and MAFLD, were significantly and positively associated with all T-scores, while hepatic fibrosis index and FIB-4 score, but not NAFLD fibrosis score (NFS), were negatively associated with all T-scores. MAFLD was significantly associated with the decreased risk of osteopenia/osteoporosis and osteoporosis with unadjusted odds ratios (ORs) (95% CI) of 0.565 (0.324–0.987) and 0.434 (0.224–0.843) (both p-values < 0.05), respectively. As for liver fibrosis, FIB-4 score, but not NFS, was significantly associated with elevated risk of osteoporosis with an unadjusted OR (95% CI) per SD increase of FIB-4 score of 1.446 (1.080–1.936, p-value = 0.013). Adjusting for potential confounding variables, especially body mass index, in the multivariable regression analyses, all associations of hepatic steatosis and fibrosis indices with BMD and risk of osteopenia/osteoporosis were not statistically significant.ConclusionMAFLD and hepatic fibrosis were not significantly associated with BMD and risk of osteopenia/osteoporosis independent of obesity. Nevertheless, screening and management of MAFLD and osteopenia/osteoporosis were still important for the prevention of fracture in T2DM patients.

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“…[8,9] In addition, the prevalence of NAFLD in adolescents has climbed with the global increase in childhood obesity rates. [10] Although studies have investigated the relationship between NAFLD and BMD in the past, [11,12] however, most have focused on adult populations. Research on the relationship between NAFLD and BMD in adolescents remains scarce and controversial, and more importantly, there is a lack of gender-and race-specific correlations.…”

Section: Introductionmentioning

confidence: 99%

Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents

Xie

Zhang

Yan³

et al. 2022

Medicine

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Liver metabolism is strongly linked to bone metabolism, and a significant correlation between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) in adults has been demonstrated. However, the current relationship between NAFLD and BMD in the adolescent population remains controversial. The purpose of this study was to investigate the specific relationship between NAFLD and BMD in adolescents aged 12 to 19 years in the United States. The quantitative relationship between NAFLD and total BMD was investigated using multivariate logistic regression and smoothed fitted curve curves based on multiperspective data from the National Health and Nutrition Examination Survey (NHANES). A total of 740 adolescents were included in this study after excluding unusable samples. The results showed that NAFLD was positively associated with total BMD in adolescents. The results of the subgroup analysis showed that this positive association was mainly found in boys, whites and blacks. The association was not significant in girls, Mexican Americans and other racial groups. Among US adolescents, there was a significant positive association between NAFLD and total BMD, and this relationship varied by gender and race.

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Association of Metabolic Dysfunction-Associated Fatty Liver Disease and Liver Stiffness With Bone Mineral Density in American Adults

Cited by 10 publications

References 56 publications

Relationship between nonalcoholic fatty liver disease and bone mineral density in elderly Chinese

Relationship between nonalcoholic fatty liver disease and bone mineral density in elderly Chinese

Associations of metabolic dysfunction-associated fatty liver disease and hepatic fibrosis with bone mineral density and risk of osteopenia/osteoporosis in T2DM patients

Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents

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