<p>Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents with obesity: a meta-analysis</p>

Abstract

PurposeMany studies have reported the relationship between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) among adults. However, fewer studies on this topic have been reported in adolescents. We thus conducted a meta-analysis to show the association between NAFLD and BMD in adolescents with obesity.Materials and methodsComputer retrieval was carried out via PubMed, Embase, Cochrane Library and the Cochrane Central Register of Controlled Trials from inception to September 2018. Six published case–control studies that assessed the relationship between NAFLD and BMD were included.ResultsThe six studies included 217 obese adolescents with NAFLD and 236 controls. The meta-analysis indicated that obese children with NAFLD had a lower BMD and Z-score than the control group (weighted mean difference [WMD]–0.03, 95% CI [−0.05, –0.02], P=0.000; [WMD] −0.26, 95% CI [−0.37, −0.14], P=0.000). However, we analyzed the factor of bone mineral content, and there was no correlation between the two groups ([WMD]–55.99, 95% CI [−132.16, 20.18], P=0.150).ConclusionObese children with NAFLD are more susceptible to osteoporosis than children with only obesity. Because of the limitations related to the quantity and quality of the included literature, further studies are still needed.

On the Relationship Between Non-alcoholic Fatty Liver Disease with Body Composition and Bone Mineral Density in Overweight/Obese Adolescents

“…In contrast, Chang et al evaluated vitamin D status and BMD in obese children with NAFLD and detected no difference in vitamin D levels or age-matched BMD among children with simple steatosis, NASH children, and healthy children (34). A systematic review and meta-analysis assessing the relationship between nonalcoholic fatty liver disease and bone mineral density in obese adolescents documented that obese adolescents with NAFLD had lower BMD and thus the higher risk of osteoporosis than obese children with no NAFLD (35).…”

Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations

“…99 A recent meta-analysis of six studies has revealed that obese children with NAFLD are more susceptible to osteoporosis than children with only obesity. 13 The potential contribution of NAFLD to development of osteoporosis warrants further study. Chronic inflammatory processes, vitamin D deficiency, disturbances of growth hormone/insulin-like growth factor 1 axis are the proposed pathophysiological factors linking NAFLD with decreased bone mass.…”

“…9,10 Recent data suggest that NAFLD increases the susceptibility and/or worsen outcome of acute pancreatitis (AP), cerebrovascular accident (CVA), and osteoporosis. [11][12][13] There is growing trend of patients with NASH-related cirrhosis requiring liver transplantation (LT). 14,15 The risk of developing progressive liver disease and associated extrahepatic diseases presents a challenge to the healthcare system to develop effective strategies in order to prevent an exponential increase in morbidity and mortality related to it.…”

Bone marrow fat change in pediatric patients with non-alcoholic fatty liver disease

“…Obese children with NAFLD are more susceptible to low bone mineral density than children without obesity or NAFLD [14,15]. However, there are limited studies about BM fat content in pediatric NAFLD patients, and the published studies report discrepant results [16,17].…”