Hepatic Steatosis is Negatively Associated with Bone Mineral Density in Children

Chun, Lauren F; Yu, Elizabeth L.; Sawh, Mary Catherine; Bross, Craig; Nichols, Jeanne F.; Polgreen, Lynda E.; Knott, Cynthia; Schlein, Alexandra; Sirlin, Claude B.; Middleton, Michael S.; Kado, Deborah M.; Schwimmer, Jeffrey B.

doi:10.1016/j.jpeds.2021.01.064

Cited by 8 publications

(3 citation statements)

References 44 publications

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“…NAFLD can worsen insulin resistance and trigger the production of a slew of pro-inflammatory cytokines and bone-influencing molecules, all of which can contribute to bone demineralization and osteoporosis ( 30 , 31 ). In addition to this, there is growing evidence that NAFLD causes alterations in the production of several molecular coordinators that may be detrimental to bone health, such as overproduction of TNF-a ( 32 ) and deficiencies in vitamin D ( 33 ), osteopontin ( 34 ) and osteoprotegerin ( 35 ). Moreover, circulating molecules may have different effects on bone metabolism by affecting early childhood obesity ( 36 ) or the progression of NAFLD ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density

Xie

Liu

2022

Front. Endocrinol.

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BackgroundThe liver and bones are both active endocrine organs that carry out several metabolic functions. However, the link between non-alcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) is still controversial. The goal of this study was to discover if there was a link between non-alcoholic fatty liver disease and bone mineral density in US persons aged 20 to 59 years of different genders and races.MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018, multivariate logistic regression models were utilized to investigate the association between NAFLD and lumbar BMD. Fitted smoothing curves and generalized additive models were also used.ResultsThe analysis included a total of 1980 adults. After controlling for various variables, we discovered that NAFLD was negatively linked with lumbar BMD. The favorable connection of NAFLD with lumbar BMD was maintained in subgroup analyses stratified by sex, race and age in men, other race and aged 20-29 years. The relationship between NAFLD and lumbar BMD in blacks and people aged 40-49 years was a U-shaped curve with the inflection point: at 236dB/m and 262dB/m. Furthermore, we discovered that liver advanced fibrosis and liver cirrhosis were independently connected with higher BMD, while no significant differences were detected in severe liver steatosis and BMD.ConclusionsOur study found an independently unfavorable relationship between NAFLD and BMD in persons aged 20 to 59. We also discovered a positive link between BMD and advanced fibrosis and cirrhosis. More research is needed to back up the findings of this study and to look into the underlying issues.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density

Xie

Liu

2022

Front. Endocrinol.

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“…Bone mineralization during adolescence is critical for preventing future osteoporosis and reducing fracture risk because during childhood or adolescence, the development and growth of bone mass is faster, so measures need to be taken to prevent osteoporosis as well [6,7]. Although osteoporosis usually manifests itself in old age, a small percentage of people also develop it in childhood and adolescence [8].…”

Section: Introductionmentioning

confidence: 99%

Inverted U-shaped relationships between bone mineral density and VCTE-quantified degree of hepatic steatosis in adolescents: Evidence from the NHANES

Zhang

Tan

et al. 2023

PLoS ONE

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Introduction There may be inaccuracies in hepatic steatosis in past research assessing the relationship between bone metabolism and liver steatosis. The goal of the current research was to look at the associations between bone mineral density (BMD) and the hepatic steatosis and fibrosis as detected by vibration-controlled transient elastography (VCTE) in teenagers in the United States. Methods Weighted multiple linear regression models and smoothed curve fitting were used to investigate the association between BMD and the degree of hepatic steatosis and fibrosis in adolescents. Results In 829 adolescents aged 12–19 years we found a negative association between total BMD and CAP (controlled attenuation parameter) [-32.46 (-58.98, -9.05)] and a significant positive association between lumbar BMD and LSM (liver stiffness measurement) [1.35 (0.19, 2.51)]. The inverted U-shaped relationships were founded between total BMD, lumbar BMD, pelvis BMD, and CAP with inflection points of 221.22 dB/m, 219.88 dB/m, and 216.02 dB/m, respectively. Conclusions In adolescents, higher BMD is significantly associated with lower levels of hepatic steatosis and higher levels of liver stiffness.

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“…14,15 A meta-analysis conducted by Mantovani et al10 in 2019 on 632 children showed that those with MASLD have lower BMD than the non-MASLD group, and the severity of MASLD was also associated with reduced BMD. Another meta-analysis conducted by Sun et al…”

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confidence: 99%

Effects of Metabolic Dysfunction-Associated Steatotic Liver Disease on Bone Density and Fragility Fractures: Associations and Mechanisms

Khanmohammadi,

Kuchay

2024

Journal of Obesity & Metabolic Syndrome

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Metabolic dysfunction-associated steatotic liver disease (MASLD) has profound adverse effects on bone health and homeostasis. MASLD appears to be associated with changes in bone mineral density (BMD) and fracture rate. However, the data are ambiguous and conflicting. Although several studies have shown that children and adolescents with MASLD have decreased BMD, the data on the prevalence of fragility fractures among children are scarce. In adults, increasing evidence suggests that MASLD decreases BMD and increases the risk of fragility fractures, which appears to be due to deterioration of bone architecture in addition to a decrease in BMD. Effects of MASLD on bone health may also be age-and race-specific. MASLD does not seem to increase fracture risk in children and adolescents but increases the risk of fractures in elderly men, especially those of Asian origin.From a mechanistic perspective, bone remodeling is a continuous process between osteoblasts (boneforming) and osteoclasts (bone-resorbing), with any imbalance resulting in metabolic bone disease. In individuals with MASLD, loss of anabolic insulin receptor signaling (insulin resistance) in osteoblasts and increased receptor activator of nuclear factor κB (RANK)/RANK ligand (RANKL) signaling in osteoclasts (proinflammatory cytokines) swings the pendulum toward accelerated bone loss. These processes are further complicated by the concomitant presence of obesity, type 2 diabetes mellitus, or sarcopenia in individuals with MASLD. This study reviews the current literature associated with the effects of MASLD on BMD and fragility fractures in children/adolescents and adults. This review also discusses the pathomechanisms that link MASLD with changes in BMD and fragility fractures.

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Hepatic Steatosis is Negatively Associated with Bone Mineral Density in Children

Cited by 8 publications

References 44 publications

Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density

Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density

Inverted U-shaped relationships between bone mineral density and VCTE-quantified degree of hepatic steatosis in adolescents: Evidence from the NHANES

Effects of Metabolic Dysfunction-Associated Steatotic Liver Disease on Bone Density and Fragility Fractures: Associations and Mechanisms

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