Abstract
BackgroundRecent studies have linked non-alcoholic fatty liver disease (NAFLD) to a reduced bone mineral density (BMD). We aimed to detect the quantitative association of liver fat content (LFC) and serum alanine aminotransferase (ALT) with BMD in a middle-aged and elderly Chinese population.MethodsThe lumbar spine, hip and whole body BMDs were measured using dual-energy x-ray absorptiometry (Lunar iDXA, GE Healthcare) in 1659 Chinese (755 men and 1028 postmenopausal women) from Shanghai Changfeng community. Liver fat content was quantified via an ultrasound quantitative method. Multivariate linear regression analyses were carried out to determine the independent association of LFC and serum ALT with BMD and bone metabolic biomarkers. We also attempted to investigate the synergistic association between LFC and ALT as risk factors for bone mineral loss in Chinese.ResultsSubjects with higher LFC had significantly lower BMD at all skeletal sites. Univariate correlation analysis showed that both LFC and ALT were inversely associated with BMD at the spine (r = −0.116, P < 0.001 and r = −0.102, P = 0.005), hip (r = −0.095, P = 0.014 and r = −0.075, P = 0.041) and whole body sites (r = −0.134, P < 0.001 and r = −0.164, P < 0.001) in men. After confounders were controlled for, LFC and ALT remained associated with BMD and bone formation biomarkers in men, but not postmenopausal women. When both NAFLD and elevation of ALT were present, there was a significant synergistic worsening of the BMDs at all bone sites.ConclusionsLiver fat content and serum ALT were inversely correlated with BMD in middle-aged and elderly men. The underlying mechanism might relate to a reduction in osteoblast activity. Elevation of the hepatotoxic biomarker ALT may indicate high risk for osteoporosis in patients with NAFLD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-016-0766-3) contains supplementary material, which is available to authorized users.
Highlights
Recent studies have linked non-alcoholic fatty liver disease (NAFLD) to a reduced bone mineral density (BMD)
The associations of liver fat content (LFC) and hepatotoxic biomarker alanine aminotransferase (ALT) with BMD have not been fully studied, and the mechanisms underlying the association between NAFLD and bone mineral loss are still not clear
Higher LFC was in parallel with higher BF %, trunk fat mass, appendicular fat mass and trunkappendicular fat ratio, and correlated with higher liver enzymes, blood pressure, fbg and unfavourable lipid profiles (All P < 0.05)
Summary
Recent studies have linked non-alcoholic fatty liver disease (NAFLD) to a reduced bone mineral density (BMD). We aimed to detect the quantitative association of liver fat content (LFC) and serum alanine aminotransferase (ALT) with BMD in a middle-aged and elderly Chinese population. As the incidence of obesity reaches the epidemic level worldwide, non-alcoholic fatty liver disease (NAFLD) is becoming a main public health concern [1, 2]. Osteoporosis, characterized by decrease of body bone mineral density (BMD), is an important public. The associations of liver fat content (LFC) and hepatotoxic biomarker alanine aminotransferase (ALT) with BMD have not been fully studied, and the mechanisms underlying the association between NAFLD and bone mineral loss are still not clear
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