Abstract
The present study evaluated the potential combined effects of NAFLD and MetS on the development of osteoporosis. The relationship between NAFLD and MetS and osteoporosis was assessed in 938 postmenopausal female participants. Moderate and severe NAFLDs were combined as significant NAFLD (SNAFLD). All the subjects were divided into 4 subgroups based on the status of SNAFLD and MetS. Relative excess risk of interaction (RERI), attributable proportion (AP) of interaction, and synergy index (SI) were used to investigate the additive interaction of those two factors. NAFLD, SNAFLD, and MetS were independent factors for osteoporosis with the adjustment of age and other confounders. The incidence of osteoporosis in MetS (+) SNAFLD (+) group was significantly higher than that in other three groups. RERI was 2.556 (95% CI = 0.475–4.636), AP was 0.454 (95% CI = 0.201–0.706), and SI was 2.231 (95% CI = 1.124 to 4.428), indicating the significant combined interaction of SNAFLD and MetS on the development of osteoporosis. SNAFLD and MetS are independent risk factors for osteoporosis in postmenopausal females, respectively. Moreover, SNAFLD and MetS have an additive effect on the development of osteoporosis.
Highlights
Osteoporosis is defined as a systemic skeletal disease that reduces bone strength and enhances the risk of bone fractures, which result from alteration of bone mass and microstructure
In model 2, except that MetS and age were still risk factors for the osteoporosis, significant NAFLD (SNAFLD) was significantly correlated with osteoporosis
We found that the value of risk of interaction (RERI) was 2.556 with 95% confidence interval (CI) ranged 0.475 to 4.636, which indicated that there was a strong additive interaction between SNAFLD and MetS on osteoporosis, and there would be 2.556 relative excess risk that contributed by the additive interaction
Summary
Osteoporosis is defined as a systemic skeletal disease that reduces bone strength and enhances the risk of bone fractures, which result from alteration of bone mass and microstructure. According to the World Health Organization (WHO) definition, osteoporosis is identified as a bone mineral density (BMD) that lies 2.5 standard deviations (SDs) or more below the average for the young healthy adults [1]. It has been anticipated that the osteoporosis population in China will climb dramatically from 83.9 million to 212 million from 1997 to 2050 [2]. Osteoporosis is an important public health issue in China. Li et al [3] investigated
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