ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
The relationship between fatty liver index and bone mineral density in Koreans: KNHANES 2010-2011.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Fatty liver index (FLI): more than a marker of hepatic steatosis.Journal of physiology and biochemistry · 2024Pooled it
- [Liver-bone axis: novel mechanisms and strategies for MAFLD regulation].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- The contested association between MASLD and osteoporosis: a narrative review of heterogeneous evidence and modifying factors.Archives of osteoporosis · 2026Review
- Liver fat fraction negatively correlates with lumbar BMD in normal body mass index postmenopausal women: mediated by bone marrow fat.Frontiers in endocrinology · 2026Article
- The impact of obesity on bone health: molecular pathways, metabolic interactions, and associated pathologies.International journal of obesity (2005) · 2026Review
- Differential Impact of Interferon-Based and Direct-Acting Antiviral Therapies on Bone Metabolism in Chronic Hepatitis C: Insights from Transcriptomic and Clinical Analyses.Calcified tissue international · 2025Observational
- Article
- Association of the Chinese visceral adiposity index with marrow adiposity in postmenopausal females.Frontiers in endocrinology · 2025Article
- Osteosarcopenia in metabolic dysfunction-associated steatotic liver disease: from mechanisms to management.Frontiers in endocrinology · 2025Review
- Bone Loss and Fractures in Post-Menopausal Women Living with HIV: A Narrative Review.Pathogens (Basel, Switzerland) · 2024Review
- Association between nonalcoholic fatty liver disease and bone mineral density: Mendelian randomization and mediation analysis.Bone reports · 2024Article
- Article
- Association of chronic liver disease with bone diseases and muscle weakness.Journal of bone and mineral metabolism · 2024Review
- Association between fatty liver index and controlled attenuation parameters as markers of metabolic dysfunction-associated fatty liver disease and bone mineral density: observational and two-sample Mendelian randomization studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Observational
- Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe.Frontiers in endocrinology · 2024Review
- Vertebral marrow fat fraction is associated with circulating RANKL in postmenopausal females.Frontiers in endocrinology · 2024Article
- Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease.International journal of molecular sciences · 2023Review
- Metabolic associated fatty liver disease and bone mineral density: a cross-sectional study of the National Health and Nutrition Examination Survey 2017-2018.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies.Microorganisms · 2023Review
- Relationship between the High Fatty Liver Index and Risk of Fracture.Gut and liver · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Analyses using a nationally representative cohort have revealed that high fatty liver index (FLI) is associated with low bone mineral density (BMD) regardless of insulin resistance in men, thereby supporting the deteriorated bone metabolism in nonalcoholic fatty liver disease (NAFLD).
introductionNAFLD is linked to deteriorated bone health. We investigated the association of FLI, a scoring model for NAFLD, with BMD.
methodsThis was a population-based, cross-sectional study from the Korea National Health and Nutrition Examination Surveys including 4264 Koreans (1908 men and 2356 women). FLI was calculated using body mass index, waist circumference, serum triglyceride, and gamma-glutamyltranspeptidase level. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. BMD was measured using dual-energy X-ray absorptiometry at the lumbar spine, total hip, femoral neck, and whole body.
resultsMen had a higher FLI than women, while the HOMA-IR index was similar between men and women. The significant association between FLI and BMD was observed only in men, but not in women. FLI was negatively correlated with total hip, femoral neck, and whole body BMD in men after adjusting for all potential confounders, including HOMA-IR (P < 0.001 to 0.010). Lumbar spine, total hip, femoral neck, and whole body BMD in men showed a decreasing trend as the FLI tertile increased after adjusting for all potential confounders, including HOMA-IR (P for trends < 0.001 to 0.034). In men aged 50 years or older, odds ratios for combined osteopenia and osteoporosis increased across increasing FLI tertiles after adjusting for confounders (P for trends < 0.011 to 0.029).
conclusionNAFLD is associated with low bone density regardless of insulin resistance in men. These findings suggest an undiscovered direct link between liver and bone that increases the risk of osteoporosis in men with NAFLD.
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