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Nonalcoholic fatty liver disease and decreased bone mineral density: is there a link?
J Endocrinol Invest. 2015 Aug; 38(8):817-25.JE

Abstract

PURPOSE

Liver diseases are associated with decreased bone mineral density (BMD) and evidence suggests that nonalcoholic fatty liver disease (NAFLD) affects several extra-hepatic organs, interacting with the regulation of multiple endocrine and metabolic pathways. This review focuses on the rapidly expanding body of evidence that supports a strong association between NAFLD and the risk of decreased BMD, expression of low bone mass (osteoporosis), or reduced mineralization (osteomalacia).

METHODS

We identified studies by searching PubMed for original articles published in English through March 2015 using the keywords "nonalcoholic fatty liver disease" or "fatty liver" combined with "bone mineral density", "osteoporosis", or "osteomalacia".

RESULTS

Recent cross-sectional and case-control studies involving both adults and children have consistently shown that patients with NAFLD exhibit a greater prevalence of decreased BMD compared with age-, sex-, and body mass index-matched healthy controls. Accumulating clinical and experimental evidence suggests that NAFLD may contribute to the pathophysiology of low BMD, possibly through the direct contribution of NAFLD to whole-body and hepatic insulin resistance and/or the systemic release of multiple pro-inflammatory, pro-coagulant, and pro-fibrogenic mediators.

CONCLUSIONS

Although more research is needed before firm conclusions can be drawn, it appears that there is a non-chance, statistical association between NAFLD and low BMD. This finding argues for more careful monitoring and evaluation of BMD among patients with NAFLD. The potential contribution of NAFLD itself to the development and progression of decreased BMD warrants further study.

Authors+Show Affiliations

Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, 37126, Verona, Italy, giovanni.targher@univr.it.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26003827

Citation

Targher, G, et al. "Nonalcoholic Fatty Liver Disease and Decreased Bone Mineral Density: Is There a Link?" Journal of Endocrinological Investigation, vol. 38, no. 8, 2015, pp. 817-25.
Targher G, Lonardo A, Rossini M. Nonalcoholic fatty liver disease and decreased bone mineral density: is there a link? J Endocrinol Invest. 2015;38(8):817-25.
Targher, G., Lonardo, A., & Rossini, M. (2015). Nonalcoholic fatty liver disease and decreased bone mineral density: is there a link? Journal of Endocrinological Investigation, 38(8), 817-25. https://doi.org/10.1007/s40618-015-0315-6
Targher G, Lonardo A, Rossini M. Nonalcoholic Fatty Liver Disease and Decreased Bone Mineral Density: Is There a Link. J Endocrinol Invest. 2015;38(8):817-25. PubMed PMID: 26003827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic fatty liver disease and decreased bone mineral density: is there a link? AU - Targher,G, AU - Lonardo,A, AU - Rossini,M, Y1 - 2015/05/24/ PY - 2015/03/29/received PY - 2015/05/15/accepted PY - 2015/5/25/entrez PY - 2015/5/25/pubmed PY - 2016/4/21/medline SP - 817 EP - 25 JF - Journal of endocrinological investigation JO - J Endocrinol Invest VL - 38 IS - 8 N2 - PURPOSE: Liver diseases are associated with decreased bone mineral density (BMD) and evidence suggests that nonalcoholic fatty liver disease (NAFLD) affects several extra-hepatic organs, interacting with the regulation of multiple endocrine and metabolic pathways. This review focuses on the rapidly expanding body of evidence that supports a strong association between NAFLD and the risk of decreased BMD, expression of low bone mass (osteoporosis), or reduced mineralization (osteomalacia). METHODS: We identified studies by searching PubMed for original articles published in English through March 2015 using the keywords "nonalcoholic fatty liver disease" or "fatty liver" combined with "bone mineral density", "osteoporosis", or "osteomalacia". RESULTS: Recent cross-sectional and case-control studies involving both adults and children have consistently shown that patients with NAFLD exhibit a greater prevalence of decreased BMD compared with age-, sex-, and body mass index-matched healthy controls. Accumulating clinical and experimental evidence suggests that NAFLD may contribute to the pathophysiology of low BMD, possibly through the direct contribution of NAFLD to whole-body and hepatic insulin resistance and/or the systemic release of multiple pro-inflammatory, pro-coagulant, and pro-fibrogenic mediators. CONCLUSIONS: Although more research is needed before firm conclusions can be drawn, it appears that there is a non-chance, statistical association between NAFLD and low BMD. This finding argues for more careful monitoring and evaluation of BMD among patients with NAFLD. The potential contribution of NAFLD itself to the development and progression of decreased BMD warrants further study. SN - 1720-8386 UR - https://www.unboundmedicine.com/medline/citation/26003827/Nonalcoholic_fatty_liver_disease_and_decreased_bone_mineral_density:_is_there_a_link L2 - https://link.springer.com/article/10.1007/s40618-015-0315-6 DB - PRIME DP - Unbound Medicine ER -