Impact of the Severity of Steatosis due to Non-alcoholic Fatty Liver Disease on Bone Mineral Density in Patients with Osteoporosis

Abs tractAim: Osteoporosis can occur in individuals with liver disease, and its development is thought to be influenced by the activity of the underlying hepatic disorder, as noted in previous studies.This study aimed to investigate the influence of the degree of liver steatosis, an important indicator of non-alcoholic fatty liver disease (NAFLD) severity, on bone mineral density (BMD).Methods: Between August 2022 and July 2023, this cross-sectional study enrolled patients aged 50 to 90 years who were followed at an osteoporosis clinic and had a diagnosis of NAFLD confirmed by ultrasonography (US).Based on abdominal ultrasound findings, patients were classified into four groups reflecting the degree of liver steatosis.The groups were compared with respect to T-scores and BMD at the total spine, femur, and femoral neck, measured by dual-energy X-ray absorptiometry.Results: Of the 792 patients assessed for eligibility, 248 met the inclusion criteria.The participants had a mean age of 65.111.2years, and 97.6% (n=242) were female.The mean body mass index was 27.314.58kg/m 2 .Significant between-group differences were detected for lumbar total T-scores.A significant difference was identified in the lumbar spine T-score evaluation between the grade 3 and grade 0 groups in abdominal US imaging. Conclusion:Because NAFLD and osteoporosis share several risk factors and involve chronic inflammation, NAFLD is considered a potential risk factor for bone loss.The findings of our study demonstrate that the risk of low BMD in the lumbar spine is elevated, particularly in advanced stages of liver steatosis.