Abstract
Background & AimsNon-alcoholic fatty liver disease (NAFLD) is suggested to be associated with bone mineral density (BMD) alterations; however, this has not been ascertained. The current study aimed to investigate the changes in BMD and the prevalence of osteopenia/osteoporosis in US adults with or without NAFLD and to evaluate their association.MethodsThe study was conducted based on data collected from the U.S. National Health and Nutrition Examination Survey (NHANES) during the period 2005–2014. A total of 13 837 and 6 177 participants aged > 20 years were eligible for conducting the Hepatic Steatosis Index (HSI) and the US Fatty Liver Index (USFLI) analysis, respectively.ResultsFrom 2005–2014, a downward trend in femoral neck BMD was observed in subjects with NAFLD aged ≥ 40. After adjustment for potential confounders, an upward shift occurred in the prevalence of osteopenia/osteoporosis at the femoral neck in adults aged ≥ 40, particularly in women ≥ 60 years old and men below the age of 60. Moreover, a negative association was found between BMD and NAFLD markers (USFLI, HSI), whereas NAFLD with advanced fibrosis was positively associated with the prevalence of spine fractures.ConclusionsThere was a trend toward lower BMD and higher prevalence of osteopenia/osteoporosis at the femoral neck in US adults with NAFLD aged ≥ 40 years during the period of 2005–2014. NAFLD with advanced fibrosis was positively associated with a higher risk of spine fracture. More research is required to fully investigate the mechanism and consequence of poor bone health in NAFLD patients and consider optimum management of osteopenia/osteoporosis for this population.
Highlights
Osteoporosis is a systemic skeletal disease characterized by low bone mass and deterioration of architecture, associated with excessive bone fragility and fracture risk [1]
We investigated the temporal prevalence of osteopenia/osteoporosis through the 2005–2014 period stratified by sex and age as recommended by the Centers for Disease Control and Prevention (CDC)
A significant decreasing trend of bone mineral density (BMD) was observed at the femoral neck in participants with Non-alcoholic fatty liver disease (NAFLD) aged ≥ 40 years old throughout the decade
Summary
Osteoporosis is a systemic skeletal disease characterized by low bone mass and deterioration of architecture, associated with excessive bone fragility and fracture risk [1]. During the period 1988–1994 to 2005–2006, a decline in the prevalence of osteoporosis was observed in the US population aged ≥ 50 years [3]. By directly assessing the bone mineral density (BMD) data at various skeletal sites, more recent studies have confirmed a decline in femoral neck BMD in the US population from 2013–2014 [5]. As a chronic liver disease, NAFLD and the advanced histological phenotype non-alcoholic steatohepatitis (NASH), may have a potential link with osteoporosis, which has piqued considerable scientific interest [8]. Non-alcoholic fatty liver disease (NAFLD) is suggested to be associated with bone mineral density (BMD) alterations; this has not been ascertained. The current study aimed to investigate the changes in BMD and the prevalence of osteopenia/osteoporosis in US adults with or without NAFLD and to evaluate their association
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