Belinda T Li1, Tracey G Simon2, Na Wang3, Raymond T Chung2, Kathleen E Corey2, Laura E Dichtel4, Elizabeth J Samelson5,6, Douglas P Kiel5,6, Michelle T Long7. 1. School of Medicine, Boston University, Boston, Massachusetts, USA. 2. Liver Center, Gastroenterology Division, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, USA. 3. Biostatistics & Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, Massachusetts, USA. 4. Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, USA. 5. Hebrew Senior Life, Hinda and Arthur Marcus Institute for Aging Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 6. Harvard Medical School, Harvard University, Boston, Massachusetts, USA. 7. Section of Gastroenterology, Boston Medical Center, School of Medicine, Boston University, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is associated with low bone mineral density (BMD); however, it is not known whether early-stage NAFLD may be associated with BMD after accounting for BMI or visceral adipose tissue (VAT). METHODS: This was a cross-sectional study of 3,462 Framingham Heart Study participants who underwent computed tomographic measurement of liver fat, VAT volume, volumetric spine BMD, vertebral cross-sectional area (CSA), and vertebral compressive strength. This study excluded heavy alcohol consumers. Multivariable linear regression models were used to assess the association between NAFLD and volumetric BMD, CSA, and vertebral compressive strength after accounting for covariates, including BMI or VAT. RESULTS: A total of 2,253 participants (mean age, 51.2 [SD 10.7] years; 51.1% women) were included. In multivariable-adjusted models, positive associations between NAFLD and integral BMD, trabecular BMD, and vertebral compressive strength were observed. However, results were attenuated and no longer significant after additionally adjusting for BMI or VAT. NAFLD was observed to be weakly associated with a lower vertebral CSA in adjusted models. CONCLUSIONS: In a community-based cohort, the associations between NAFLD and BMD and vertebral strength were confounded by BMI and VAT. However, NAFLD was associated with a reduced vertebral CSA in adjusted models.
OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is associated with low bone mineral density (BMD); however, it is not known whether early-stage NAFLD may be associated with BMD after accounting for BMI or visceral adipose tissue (VAT). METHODS: This was a cross-sectional study of 3,462 Framingham Heart Study participants who underwent computed tomographic measurement of liver fat, VAT volume, volumetric spine BMD, vertebral cross-sectional area (CSA), and vertebral compressive strength. This study excluded heavy alcohol consumers. Multivariable linear regression models were used to assess the association between NAFLD and volumetric BMD, CSA, and vertebral compressive strength after accounting for covariates, including BMI or VAT. RESULTS: A total of 2,253 participants (mean age, 51.2 [SD 10.7] years; 51.1% women) were included. In multivariable-adjusted models, positive associations between NAFLD and integral BMD, trabecular BMD, and vertebral compressive strength were observed. However, results were attenuated and no longer significant after additionally adjusting for BMI or VAT. NAFLD was observed to be weakly associated with a lower vertebral CSA in adjusted models. CONCLUSIONS: In a community-based cohort, the associations between NAFLD and BMD and vertebral strength were confounded by BMI and VAT. However, NAFLD was associated with a reduced vertebral CSA in adjusted models.
Authors: Elizabeth J Samelson; Blaine A Christiansen; Serkalem Demissie; Kerry E Broe; Qiong Louie-Gao; L Adrienne Cupples; Benjamin J Roberts; Rajaram Manoharam; John D'Agostino; Thomas Lang; Douglas P Kiel; Mary L Bouxsein Journal: J Bone Miner Res Date: 2012-03 Impact factor: 6.741
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Authors: Veeral Ajmera; Emily R Perito; Nathan M Bass; Norah A Terrault; Katherine P Yates; Ryan Gill; Rohit Loomba; Anna Mae Diehl; Bradley E Aouizerat Journal: Hepatology Date: 2016-10-12 Impact factor: 17.425
Authors: Laura E Dichtel; Kathleen E Corey; Joseph Misdraji; Miriam A Bredella; Melanie Schorr; Stephanie A Osganian; Brian J Young; Joshua C Sung; Karen K Miller Journal: Clin Transl Gastroenterol Date: 2017-01-26 Impact factor: 4.488