ArticlePloS one2017
Significant liver fibrosis assessed using liver transient elastography is independently associated with low bone mineral density in patients with non-alcoholic fatty liver disease.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Association of metabolic dysfunction-associated steatotic liver disease with bone health in adults: a systematic review and meta-analysis of observational studies.Frontiers in endocrinology · 2025Pooled it
- Relationship between prevalence and risk of osteoporosis or osteoporotic fracture with non-alcoholic fatty liver disease: A systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Associations between DXA-derived parameters of body composition and bone mass density in patients with T2DM and metabolic dysfunction-associated steatotic liver disease: a cross-sectional study.BMC endocrine disorders · 2026Article
- The contested association between MASLD and osteoporosis: a narrative review of heterogeneous evidence and modifying factors.Archives of osteoporosis · 2026Review
- Laboratory biomarkers and radiographic osteolysis after total knee arthroplasty: a retrospective pilot study.Frontiers in surgery · 2026Article
- Association between liver fibrosis and osteoporosis in adults aged 50 and older: insights from the Bushehr Elderly Health Program.Journal of diabetes and metabolic disorders · 2025Article
- Increased BMD in SLD Patients Without Advanced Hepatic Fibrosis: Evidence From the NHANES 2017-2020 Database.Canadian journal of gastroenterology & hepatology · 2025Article
- Metabolic dysfunction-associated fatty liver disease and osteoporosis: the mechanisms and roles of adiposity.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Review
- Bone mass, microarchitecture and turnover among young Indian women with non-alcoholic fatty liver disease.Endocrine · 2024Article
- Environmental Cadmium Exposure Exacerbated Bone Loss in NAFLD Mice.Biological trace element research · 2024Article
- Emerging role of liver-bone axis in osteoporosis.Journal of orthopaedic translation · 2024Review
- Association of chronic liver disease with bone diseases and muscle weakness.Journal of bone and mineral metabolism · 2024Review
- The relationship between advanced liver fibrosis and osteoporosis in type 2 diabetes patients with MAFLD.Endocrine · 2024Article
- Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe.Frontiers in endocrinology · 2024Review
- Associations of metabolic dysfunction-associated fatty liver disease and hepatic fibrosis with bone mineral density and risk of osteopenia/osteoporosis in T2DM patients.Frontiers in endocrinology · 2023Article
- Risk of fractures and subsequent mortality in non-alcoholic fatty liver disease: A nationwide population-based cohort study.Journal of internal medicine · 2022Article
- Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density.Frontiers in endocrinology · 2022Article
- Hepatic fibrosis is associated with an increased rate of decline in bone mineral density in men with nonalcoholic fatty liver disease.Hepatology international · 2021Observational
- An Overview of the Molecular Mechanisms Contributing to Musculoskeletal Disorders in Chronic Liver Disease: Osteoporosis, Sarcopenia, and Osteoporotic Sarcopenia.International journal of molecular sciences · 2021Review
- Association Between Liver Fat and Bone Density is Confounded by General and Visceral Adiposity in a Community-Based Cohort.Obesity (Silver Spring, Md.) · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetabolic bone disorders frequently occur in patients with chronic liver disease; however, the association between liver fibrosis and bone mineral density in patients with non-alcoholic fatty liver disease (NAFLD) is unclear.
methodsThis is a cross-sectional analysis of 231 asymptomatic subjects (160 women, 61.6 years old) from a university hospital setting, between February 2012 and December 2014. Bone mineral density (BMD) was measured at the lumbar spine, femur neck, and total hip using dual-energy X-ray absorptiometry (DXA). Liver fibrosis and steatosis were assessed using transient elastography.
resultsAmong a total of 231 individuals, 129 subjects (55.8%) had NAFLD. BMDs at lumbar spine, femur neck, and total hip were significantly lower in patients having NAFLD with significant fibrosis, compared with patients having NAFLD without significant fibrosis (Ps<0.005). In patients with NAFLD, significant liver fibrosis revealed marked negative correlations with BMD at the lumber spine (r = -0.19, P = 0.032), femur neck (r = -0.19, P = 0.034), and total hip (r = -0.21, P = 0.016). A multivariate linear regression analysis revealed that significant liver fibrosis was independently correlated with low BMD at the femur neck (β = -0.18, P = 0.039) and total hip (β = -0.21, P = 0.005) after adjustment for age, sex, BMI, fasting plasma glucose, alanine aminotransferase, high-density lipoprotein cholesterol, and liver steatosis among patients with NAFLD. Using multivariable logistic regression, significant liver fibrosis was independently associated with overall osteopenia and osteoporosis in subjects having NAFLD (OR = 4.10, 95% CI = 1.02-16.45).
conclusionThe presence of significant liver fibrosis assessed via TE was independently associated with low BMD in NAFLD subjects.
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