ArticlePloS one2018
Nonalcoholic fatty liver disease with elevated alanine aminotransferase levels is negatively associated with bone mineral density: Cross-sectional study in U.S. adults.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 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
- Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis.BMC gastroenterology · 2020Pooled it
- The contested association between MASLD and osteoporosis: a narrative review of heterogeneous evidence and modifying factors.Archives of osteoporosis · 2026Review
- Sex Differences in MASLD After Age 50: Presentation, Diagnosis, and Clinical Implications.Biomedicines · 2025Article
- Article
- Bone mass, microarchitecture and turnover among young Indian women with non-alcoholic fatty liver disease.Endocrine · 2024Article
- Association of chronic liver disease with bone diseases and muscle weakness.Journal of bone and mineral metabolism · 2024Review
- Effects of Metabolic Dysfunction-Associated Steatotic Liver Disease on Bone Density and Fragility Fractures: Associations and Mechanisms.Journal of obesity & metabolic syndrome · 2024Review
- Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe.Frontiers in endocrinology · 2024Review
- Risk of fractures and subsequent mortality in non-alcoholic fatty liver disease: A nationwide population-based cohort study.Journal of internal medicine · 2022Article
- Association between non-alcoholic fatty liver disease and bone turnover markers in southwest China.Journal of bone and mineral metabolism · 2022Article
- Relationship Between Non-Alcoholic Fatty Liver Disease and Degree of Hepatic Steatosis and Bone Mineral Density.Frontiers in endocrinology · 2022Article
- Review
- Association Between Liver Fat and Bone Density is Confounded by General and Visceral Adiposity in a Community-Based Cohort.Obesity (Silver Spring, Md.) · 2021Article
- Prevalence of Elevated Alanine Aminotransferase by Diagnostic Criterion, Age, and Gender among Adolescents.Gastroenterology research and practice · 2020Article
- Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents with obesity: a meta-analysis.Diabetes, metabolic syndrome and obesity : targets and therapy · 2019Review
- Investigation of the influential factors for hepatic osteodystrophy in chronic liver disease: A case-control survey among the patients attending a tertiary care hospital in a rural region of Northern India.Tzu chi medical journalArticle
- Magnitude of Nonalcoholic Fatty Liver Disease: Western Perspective.Journal of clinical and experimental hepatologyReview
- EVALUATION OF NON-ALCOHOLIC FATTY LIVER DISEASE AND BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN.Acta endocrinologica (Bucharest, Romania : 2005)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonalcoholic fatty liver disease (NAFLD) has been reported to have a negative effect on bone mineral density (BMD) in Asian populations. Whether such an association exists in Western populations is less clear.
methodsThis cross-sectional analysis of data from NHANES III, a United States national health survey conducted from 1988 to 1994, included 6089 participants aged 40-75 years, selected after excluding people with hepatitis virus serology, elevated alcohol consumption, decreased renal function, or steroid use, and pregnant females. The main outcome, BMD at the femoral neck, was measured using dual-energy X-ray absorptiometry. The primary exposure, NAFLD, was defined as moderate or severe hepatic steatosis diagnosed using abdominal ultrasonography.
resultAfter controlling for gender and menopausal status, race/ethnicity, age and body mass index, NAFLD was not significantly associated with BMD (beta coefficient: -0.006, 95%CI: -0.016, 0.003). A secondary analysis categorized participants with NAFLD according to their serum alanine aminotransferase (ALT) levels into high and normal ALT NAFLD groups, and compared these with the non-NAFLD group. NAFLD with higher levels of ALT was associated with lower levels of BMD (beta coefficient: -0.023, 95% CI: -0.044, -0.002).
conclusionThis study showed a relationship between NAFLD with high ALT and lower BMD in the general U.S. population.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.