The Combined Effect of Nonalcoholic Fatty Liver Disease and Metabolic Syndrome on Osteoporosis in Postmenopausal Females in Eastern China

Chen, Da-Zhi; Xu, Qiaomai; Wu, Xiaoxin; Cai, Chao; Zhang, Lingjian; Shi, Ke‐Qing; Shi, Honglian; Li, Lanjuan

doi:10.1155/2018/2314769

Cited by 24 publications

(29 citation statements)

References 55 publications

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“…A retrospective study among Taiwanese population [n=2007, aged > 50 years] also reported no association between MetS and osteoporosis in both sexes [57]. In contrast, Chen et al [58] showed that both MetS and non-alcoholic fatty liver disease associated with it were positively associated with osteoporosis among postmenopausal women from Eastern China [n=938, aged 61.2 (SD 13.8) years].…”

Section: Discussionmentioning

confidence: 99%

Positive association between metabolic syndrome and bone mineral density among Malaysians

Chin¹,

Chan²,

Subramaniam³

et al. 2020

Int. J. Med. Sci.

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Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.

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Section: Discussionmentioning

confidence: 99%

Positive association between metabolic syndrome and bone mineral density among Malaysians

Chin¹,

Chan²,

Subramaniam³

et al. 2020

Int. J. Med. Sci.

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“…A retrospective study by Chen et al reported that both MetS and the associated non-alcoholic fatty liver disease were positively associated with osteoporosis among Chinese post-menopausal women (n=938). 24 The negative relationship was further consolidated in cross-sectional studies. Hwang and Choi reported that the lumbar spine BMD adjusted for age, weight and height decreased with increasing MetS components in Korean adult women (n=2548).…”

Section: Negative Association Between Mets and Bone Mineral Densitymentioning

confidence: 96%

Section: Relationship Between Mets and Bone Mineral Densitymentioning

confidence: 99%

“… Loke et al (2018) 28 Retrospective cross-sectional study 1162 subjects (59.5% men) from a hospital in southern Taiwan with mean age 59.9 ± 7.3 years NCEP-ATPIII MetS was associated with decreased BMD in age-adjusted model (osteoporosis+osteopenia): Men: OR 0.35, 95% CI 0.18~0.68 Women: OR 2.24, 95% CI 1.06~4.69 In men, decreased BMD was associated with: Central obesity: OR 1.06, 95% CI 1.03~1.10 Hyperglycemia: OR 0.99, 95% CI 0.99~1.00 In women, no significant relationship between decreased BMD and MetS components. Chen et al (2018) 24 Cross-sectional study 938 post-menopausal women from Eastern China Diabetes Society of Chinese Medical Association MetS (OR 2.132, 95% CI 1.166~3.900) NAFLD (OR 1.945, 95% CI 1.162~3.253) or both conditions together (OR 5.632, 95% CI 3.281~9.666) predicted higher risk of osteoporosis. Wani et al (2019) 19 Cross-sectional study 1587 subjects (84.7% women), aged > 35 years from hospitals around Riyadh city, Saudi Arabia.…”

Section: Relationship Between Mets and Bone Geometrymentioning

confidence: 99%

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<p>Relationship Between Metabolic Syndrome and Bone Health – An Evaluation of Epidemiological Studies and Mechanisms Involved</p>

Chin¹,

Wong²,

Ekeuku³

et al. 2020

DMSO

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Metabolic syndrome (MetS) and osteoporosis are two medical problems plaguing the ageing populations worldwide. Though seemingly distinctive to each other, metabolic derangements are shown to influence bone health. This review summarises the relationship between MetS and bone health derived from epidemiological studies and explains the mechanistic basis of this relationship. The discourse focuses on the link between MetS and bone mineral density, quantitative sonometric indices, geometry and fracture risk in humans. The interesting sex-specific trend in the relationship, probably due to factors related to body composition and hormonal status, is discussed. Mechanistically, each component of MetS affects the bone distinctly, forming a complex interacting network influencing the skeleton. Lastly, the effects of MetS management, such as pharmacotherapies, exercise and bariatric surgery, on bone, are presented. This review aims to highlight the significant relationship between MetS and bone, and proper management of MetS with the skeletal system in mind could prevent cardiovascular and bone complications.

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“…Less is known about non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). The mean prevalence of HOD in this patient group, often composed of children, is reported to be 45.7% [22,23,24]. Approximately every second patient (49.3%) with hemochromatosis shows altered bone structure (osteopenia or osteoporosis) [25,26,27].…”

Section: Hepatic Osteodystrophy—definition and Prevalencementioning

confidence: 99%

Hepatic Osteodystrophy—Molecular Mechanisms Proposed to Favor Its Development

Ehnert¹,

Aspera-Werz²,

Ruoß³

et al. 2019

IJMS

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Almost all patients with chronic liver diseases (CLD) show altered bone metabolism. Depending on the etiology, this manifests in a severe osteoporosis in up to 75% of the affected patients. Due to high prevalence, the generic term hepatic osteodystrophy (HOD) evolved, describing altered bone metabolism, decreased bone mineral density, and deterioration of bone structure in patients with CLD. Once developed, HOD is difficult to treat and increases the risk of fragility fractures. Existing fractures affect the quality of life and, more importantly, long-term prognosis of these patients, which presents with increased mortality. Thus, special care is required to support the healing process. However, for early diagnosis (reduce fracture risk) and development of adequate treatment strategies (support healing of existing fractures), it is essential to understand the underlying mechanisms that link disturbed liver function with this bone phenotype. In the present review, we summarize proposed molecular mechanisms favoring the development of HOD and compromising the healing of associated fractures, including alterations in vitamin D metabolism and action, disbalances in transforming growth factor beta (TGF-β) and bone morphogenetic protein (BMP) signaling with histone deacetylases (HDACs) as secondary regulators, as well as alterations in the receptor activator of nuclear factor kappa B ligand (RANKL)–osteoprotegerin (OPG) system mediated by sclerostin. Based on these mechanisms, we give an overview on the limitations of early diagnosis of HOD with established serum markers.

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The Combined Effect of Nonalcoholic Fatty Liver Disease and Metabolic Syndrome on Osteoporosis in Postmenopausal Females in Eastern China

Cited by 24 publications

References 55 publications

Positive association between metabolic syndrome and bone mineral density among Malaysians

Positive association between metabolic syndrome and bone mineral density among Malaysians

<p>Relationship Between Metabolic Syndrome and Bone Health – An Evaluation of Epidemiological Studies and Mechanisms Involved</p>

Hepatic Osteodystrophy—Molecular Mechanisms Proposed to Favor Its Development

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