Nonalcoholic Fatty Liver Disease Is Associated With Decreased Bone Mineral Density in Adults: A Systematic Review and Meta-Analysis

IF 5.1 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Bone and Mineral Research Pub Date : 2023-05-30 DOI:10.1002/jbmr.4862

Ying-Hao Su, Kuo-Liong Chien, Shu-Hua Yang, Wei-Tso Chia, Jen-Hau Chen, Yen-Ching Chen

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引用次数: 1

Abstract

This systematic review and meta‐analysis aimed to investigate the effect of nonalcoholic fatty liver disease (NAFLD) on bone mineral density (BMD) and the risk of osteoporosis and osteoporotic fracture in adults. We searched PubMed, MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library, and Scopus for observational studies published from inception to January 2023 that reported adjusted effect sizes of NAFLD on BMD, osteopenia/osteoporosis, and osteoporotic fracture. The data were synthesized using multilevel and random‐effects models. A total of 19 studies were included; of these, nine (21,294 participants) evaluated the effect of NAFLD on BMD, six (133,319 participants) investigated the risk of osteoporosis, and five (227,901 participants) assessed the risk of osteoporotic fracture. This meta‐analysis showed that NAFLD was associated with decreased BMD (mean difference −0.019 g/cm2, 95% confidence interval [CI] −0.036 to −0.002, I2 = 93%) and increased risks of osteoporosis (adjusted risk ratio [RR] = 1.28, 95% CI 1.08 to 1.52, I2 = 84%) and osteoporotic fractures (adjusted RR = 1.17, 95% CI 1.00 to 1.37, I2 = 67%). Subgroup analyses revealed that NAFLD had a significantly detrimental effect on BMD in men and on the BMD of the femoral neck and total hip. Stratified analyses by ethnicity demonstrated that NAFLD was not associated with BMD, osteoporosis, or osteoporotic fracture in non‐Asian populations. The publication bias of all included studies was low; however, there was considerable heterogeneity among the studies, warranting a careful interpretation of the findings. Overall, our results suggest that NAFLD is associated with decreased BMD and an increased risk of osteoporosis or osteoporotic fractures. Male sex and the BMD of the femoral neck and total hip may be potential risk factors for decreased BMD in adults with NAFLD. Additionally, ethnic disparities were observed between Asian and non‐Asian populations regarding BMD and osteoporotic fractures. © 2023 American Society for Bone and Mineral Research (ASBMR).

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成人非酒精性脂肪性肝病与骨密度降低相关:一项系统综述和荟萃分析

本系统综述和荟萃分析旨在探讨非酒精性脂肪性肝病(NAFLD)对成人骨矿物质密度(BMD)和骨质疏松和骨质疏松性骨折风险的影响。我们检索了PubMed, MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library和Scopus从成立到2023年1月发表的观察性研究，这些研究报告了NAFLD对BMD，骨质减少/骨质疏松症和骨质疏松性骨折的调整效应大小。采用多水平和随机效应模型对数据进行综合。共纳入19项研究;其中，9项(21294名参与者)评估NAFLD对骨密度的影响，6项(133319名参与者)调查骨质疏松症的风险，5项(227901名参与者)评估骨质疏松性骨折的风险。该荟萃分析显示，NAFLD与骨密度降低(平均差值为- 0.019 g/cm2, 95%可信区间[CI] - 0.036 ~ - 0.002, I2 = 93%)、骨质疏松(校正风险比[RR] = 1.28, 95% CI 1.08 ~ 1.52, I2 = 84%)和骨质疏松性骨折(校正风险比[RR] = 1.17, 95% CI 1.00 ~ 1.37, I2 = 67%)相关。亚组分析显示NAFLD对男性骨密度以及股骨颈和全髋的骨密度有显著的不利影响。种族分层分析表明，在非亚洲人群中，NAFLD与骨密度、骨质疏松或骨质疏松性骨折无关。所有纳入研究的发表偏倚均较低;然而，这些研究之间存在相当大的异质性，需要对研究结果进行仔细的解释。总的来说，我们的研究结果表明NAFLD与骨密度降低和骨质疏松或骨质疏松性骨折的风险增加有关。男性、股骨颈和全髋的骨密度可能是NAFLD患者骨密度降低的潜在危险因素。此外，亚洲和非亚洲人群在骨密度和骨质疏松性骨折方面存在种族差异。©2023美国骨与矿物研究学会(ASBMR)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Bone and Mineral Research 医学-内分泌学与代谢

CiteScore

11.30

自引率

6.50%

发文量

257

审稿时长

2 months

期刊介绍： The Journal of Bone and Mineral Research (JBMR) publishes highly impactful original manuscripts, reviews, and special articles on basic, translational and clinical investigations relevant to the musculoskeletal system and mineral metabolism. Specifically, the journal is interested in original research on the biology and physiology of skeletal tissues, interdisciplinary research spanning the musculoskeletal and other systems, including but not limited to immunology, hematology, energy metabolism, cancer biology, and neurology, and systems biology topics using large scale “-omics” approaches. The journal welcomes clinical research on the pathophysiology, treatment and prevention of osteoporosis and fractures, as well as sarcopenia, disorders of bone and mineral metabolism, and rare or genetically determined bone diseases.