Relationship between nonalcoholic fatty liver disease and bone mineral density in type 2 diabetic patients

Purpose To analyze the relationships between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) in type 2 diabetes (T2DM) patients. Methods A total of 446 men aged ≥ 50 years and 306 postmenopausal women with T2DM were recruited. The differences of BMD levels in T2DM patients with or without NAFLD were analyzed. According to the tertile levels of BMD, T2DM patients with NAFLD were divided into three groups (T1, T2, and T3), and the differences in the prevalence of NAFLD were compared among the three groups. The independent influencing factors of NAFLD were analyzed. Results The right calcaneus and left forearm BMD levels of male and postmenopausal female T2DM patients with NAFLD were lower than those without NAFLD. After grouping according to the tertile levels of BMD of the right calcaneus, the prevalence of NAFLD in the T1 group (56.8%) was higher than that in the T2 or T3 group (42.6% or 40.7%) among male T2DM patients, and the prevalence of NAFLD in the T1 group was higher than that in the T3 group (77.2% vs . 53.5%) among postmenopausal female T2DM patients. NAFLD was negatively associated with the right calcaneus and the left forearm BMD, and the right calcaneus BMD was an independent protective factor for NAFLD in male and postmenopausal female T2DM patients (OR = 0.014 and 0.006, p