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ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Metabolic dysfunction-associated steatotic liver disease is associated with higher bone mineral density: results from NHANES.

Jinmin Liu, Hongwei Zhan, Zhi Yi, Cong Tian, Bin Geng

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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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Jinmin Liu *Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China.
Hongwei Zhan *Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China.
Zhi Yi *Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China.
Cong TianDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China.
Bin GengDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China. cxxxf@foxmail.com.ORCID http://orcid.org/0000-0002-1541-085X

Funding

National Natural Science Foundation of China 81960403Natural Science Foundation of Gansu Province for Distinguished Young Scholars 22JR5RA943
6 · The paper itself

Abstract

We used data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and bone mineral density (BMD) among U.S. adults. Our findings indicated that participants with MASLD had higher BMD than those without MASLD.

introductionGiven the stigma associated with the term "NAFLD," experts participating in a Delphi consensus proposed renaming the condition "MASLD". Nevertheless, the association between MASLD and BMD remains unclear. This study aimed to investigate the relationship between MASLD and BMD.

methodsA cross-sectional study was conducted among 6470 participants aged 18 years or older using data from the 2005 to 2010, 2013 to 2014, and 2017 to 2018 cycles of the NHANES. MASLD was defined according to diagnostic criteria established through a Delphi consensus. Multivariable linear regression analyses were performed to evaluate the associations of MASLD with femoral neck and total femur BMD, while logistic regression analysis was used to investigate the association between MASLD and osteoporosis.

resultsAmong the 6470 participants, the mean age was 53.16 ± 17.27 years, 49.54% were male, and 23.52% met the criteria for MASLD. After multivariable adjustment, participants with MASLD had higher femoral neck BMD (β = 0.0238; 95% CI, 0.0154-0.0321) and total femur BMD (β = 0.0332; 95% CI, 0.0244-0.0419) than those without MASLD. In subgroup analyses, participants with individual cardiometabolic components of MASLD, including BMI ≥ 25 kg/m², diabetes, hypertension, and hyperlipidemia, also exhibited higher femoral BMD after multivariable adjustment. Moreover, multivariable logistic regression analysis indicated that MASLD was significantly associated with lower odds of osteoporosis.

conclusionsOur findings suggest that participants with MASLD have higher BMD compared to those without MASLD.

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BMDMASLDNAFLDOsteoporosis

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