Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease
Background and purpose Chronic liver diseases are associated with increased bone fracture risk, mostly in end-stage disease and cirrhosis; besides, data in non-alcoholic fatty liver disease (NAFLD) are limited. Aim of this study was to investigate bone mineralization and microstructure in obese indi...
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| Veröffentlicht in: | Hepatology international 2023-04, Vol.17 (2), p.357-366 |
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| creator | Barchetta, Ilaria Lubrano, Carla Cimini, Flavia Agata Dule, Sara Passarella, Giulia Dellanno, Arianna Di Biasio, Alberto Leonetti, Frida Silecchia, Gianfranco Lenzi, Andrea Cavallo, Maria Gisella |
| description | Background and purpose
Chronic liver diseases are associated with increased bone fracture risk, mostly in end-stage disease and cirrhosis; besides, data in non-alcoholic fatty liver disease (NAFLD) are limited. Aim of this study was to investigate bone mineralization and microstructure in obese individuals with NAFLD in relation to the estimated liver fibrosis.
Methods
For this cross-sectional investigation, we analyzed data from 1872 obese individuals (44.6 ± 14.1 years, M/F: 389/1483; BMI: 38.3 ± 5.3 kg/m
2
) referring to the Endocrinology outpatient clinics of Sapienza University, Rome, Italy. Participants underwent clinical work-up, Dual-Energy X-ray Absorptiometry for assessing bone mineral density (BMD) and microarchitecture (trabecular bone score, TBS). Liver fibrosis was estimated by Fibrosis Score 4 (FIB-4). Serum parathyroid hormone (PTH), 25(OH) vitamin D, osteocalcin and IGF-1 levels were measured.
Results
Obese individuals with osteopenia/osteoporosis had greater FIB-4 than those with normal BMD (
p
|
| doi_str_mv | 10.1007/s12072-022-10461-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2754859571</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2754859571</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-564b470c53d1513ab45f3a5827d9495e4510e258db7600016377b8cdbc3944f3</originalsourceid><addsrcrecordid>eNp9kctu1TAQhiMEojdegAWyxKabwPieLFFFAelIbLq3fEvrKrEPtlNU3qHvjE9TisQCydKMx9_8Y_vvurcYPmAA-bFgApL0QEiPgQnc4xfdMR6p6IEz_PI5p_SoOynlFoBzgcXr7ogKToBKedw97MKdz2gKJqcSCmpLl5Js0NU79DPUGxSWvQ657UyKHi0h-qzn8EvXkCLS0bWSbc01r7au2aMQUTK-HBIX7oJb9Vw2pZhir2ebbtIcLJp0rfdofpzvQvG6-LPu1dRo_-YpnnZXl5-vLr72u-9fvl182vWWSl57LphhEiynDnNMtWF8opoPRLqRjdwzjsETPjgjBQBg0Z5qBuuMpSNjEz3tzjfZfU4_Vl-qWkKxfp519GktikjOBj5yiRv6_h_0Nq05tsspMgADyohgjSIbdfiIkv2k9jksOt8rDOrgldq8Us0r9eiVOki_e5JezeLdc8sfcxpAN6C0o3jt89_Z_5H9DWLAoMA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2804034264</pqid></control><display><type>article</type><title>Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Barchetta, Ilaria ; Lubrano, Carla ; Cimini, Flavia Agata ; Dule, Sara ; Passarella, Giulia ; Dellanno, Arianna ; Di Biasio, Alberto ; Leonetti, Frida ; Silecchia, Gianfranco ; Lenzi, Andrea ; Cavallo, Maria Gisella</creator><creatorcontrib>Barchetta, Ilaria ; Lubrano, Carla ; Cimini, Flavia Agata ; Dule, Sara ; Passarella, Giulia ; Dellanno, Arianna ; Di Biasio, Alberto ; Leonetti, Frida ; Silecchia, Gianfranco ; Lenzi, Andrea ; Cavallo, Maria Gisella</creatorcontrib><description><![CDATA[Background and purpose
Chronic liver diseases are associated with increased bone fracture risk, mostly in end-stage disease and cirrhosis; besides, data in non-alcoholic fatty liver disease (NAFLD) are limited. Aim of this study was to investigate bone mineralization and microstructure in obese individuals with NAFLD in relation to the estimated liver fibrosis.
Methods
For this cross-sectional investigation, we analyzed data from 1872 obese individuals (44.6 ± 14.1 years, M/F: 389/1483; BMI: 38.3 ± 5.3 kg/m
2
) referring to the Endocrinology outpatient clinics of Sapienza University, Rome, Italy. Participants underwent clinical work-up, Dual-Energy X-ray Absorptiometry for assessing bone mineral density (BMD) and microarchitecture (trabecular bone score, TBS). Liver fibrosis was estimated by Fibrosis Score 4 (FIB-4). Serum parathyroid hormone (PTH), 25(OH) vitamin D, osteocalcin and IGF-1 levels were measured.
Results
Obese individuals with osteopenia/osteoporosis had greater FIB-4 than those with normal BMD (
p
< 0.001). FIB-4 progressively increased in presence of degraded bone microarchitecture (
p
< 0.001) and negatively correlated with the serum osteocalcin (
p
< 0.001) and IGF-1 (
p
< 0.001), which were both reduced in presence of osteopenia/osteoporosis. FIB-4 predicted IGF-1 reduction in multivariable regression models adjusted for confounders (
β
: − 0.18,
p
< 0.001). Higher FIB-4 predicted bone fragility with OR 3.8 (95%C.I:1.5–9.3); this association persisted significant after adjustment for sex, age, BMI, diabetes, smoking status and PTH at the multivariable logistic regression analysis (OR 1.91 (95%C.I:1.15–3.17),
p
< 0.01), with AUROC = 0.842 (95%C.I:0.795–0.890;
p
< 0.001).
Conclusion
Our data indicate the presence of a tight relation between NAFLD-related liver fibrosis, lower bone mineral density and degraded microarchitecture in obese individuals, suggesting potential common pathways underlying liver and bone involvement in obesity and insulin resistance-associated disorders.]]></description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-022-10461-1</identifier><identifier>PMID: 36520377</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Bone Density ; Bone mineral density ; Calcification, Physiologic ; Cancellous bone ; Cirrhosis ; Colorectal Surgery ; Computer architecture ; Cross-Sectional Studies ; Diabetes mellitus ; Dual energy X-ray absorptiometry ; Endocrinology ; Fatty liver ; Fibrosis ; Fragility ; Health risks ; Hepatology ; Humans ; Insulin ; Insulin resistance ; Insulin-Like Growth Factor I ; Insulin-like growth factors ; Liver ; Liver Cirrhosis - complications ; Liver diseases ; Medicine ; Medicine & Public Health ; Metabolic syndrome ; Microstructure ; Mineralization ; Non-alcoholic Fatty Liver Disease - complications ; Obesity ; Obesity - complications ; Original Article ; Osteocalcin ; Osteopenia ; Osteoporosis ; Osteoporosis - complications ; Parathyroid hormone ; Regression analysis ; Regression models ; Surgery ; Vitamin D</subject><ispartof>Hepatology international, 2023-04, Vol.17 (2), p.357-366</ispartof><rights>Asian Pacific Association for the Study of the Liver 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. Asian Pacific Association for the Study of the Liver.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-564b470c53d1513ab45f3a5827d9495e4510e258db7600016377b8cdbc3944f3</citedby><cites>FETCH-LOGICAL-c375t-564b470c53d1513ab45f3a5827d9495e4510e258db7600016377b8cdbc3944f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-022-10461-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-022-10461-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36520377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barchetta, Ilaria</creatorcontrib><creatorcontrib>Lubrano, Carla</creatorcontrib><creatorcontrib>Cimini, Flavia Agata</creatorcontrib><creatorcontrib>Dule, Sara</creatorcontrib><creatorcontrib>Passarella, Giulia</creatorcontrib><creatorcontrib>Dellanno, Arianna</creatorcontrib><creatorcontrib>Di Biasio, Alberto</creatorcontrib><creatorcontrib>Leonetti, Frida</creatorcontrib><creatorcontrib>Silecchia, Gianfranco</creatorcontrib><creatorcontrib>Lenzi, Andrea</creatorcontrib><creatorcontrib>Cavallo, Maria Gisella</creatorcontrib><title>Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description><![CDATA[Background and purpose
Chronic liver diseases are associated with increased bone fracture risk, mostly in end-stage disease and cirrhosis; besides, data in non-alcoholic fatty liver disease (NAFLD) are limited. Aim of this study was to investigate bone mineralization and microstructure in obese individuals with NAFLD in relation to the estimated liver fibrosis.
Methods
For this cross-sectional investigation, we analyzed data from 1872 obese individuals (44.6 ± 14.1 years, M/F: 389/1483; BMI: 38.3 ± 5.3 kg/m
2
) referring to the Endocrinology outpatient clinics of Sapienza University, Rome, Italy. Participants underwent clinical work-up, Dual-Energy X-ray Absorptiometry for assessing bone mineral density (BMD) and microarchitecture (trabecular bone score, TBS). Liver fibrosis was estimated by Fibrosis Score 4 (FIB-4). Serum parathyroid hormone (PTH), 25(OH) vitamin D, osteocalcin and IGF-1 levels were measured.
Results
Obese individuals with osteopenia/osteoporosis had greater FIB-4 than those with normal BMD (
p
< 0.001). FIB-4 progressively increased in presence of degraded bone microarchitecture (
p
< 0.001) and negatively correlated with the serum osteocalcin (
p
< 0.001) and IGF-1 (
p
< 0.001), which were both reduced in presence of osteopenia/osteoporosis. FIB-4 predicted IGF-1 reduction in multivariable regression models adjusted for confounders (
β
: − 0.18,
p
< 0.001). Higher FIB-4 predicted bone fragility with OR 3.8 (95%C.I:1.5–9.3); this association persisted significant after adjustment for sex, age, BMI, diabetes, smoking status and PTH at the multivariable logistic regression analysis (OR 1.91 (95%C.I:1.15–3.17),
p
< 0.01), with AUROC = 0.842 (95%C.I:0.795–0.890;
p
< 0.001).
Conclusion
Our data indicate the presence of a tight relation between NAFLD-related liver fibrosis, lower bone mineral density and degraded microarchitecture in obese individuals, suggesting potential common pathways underlying liver and bone involvement in obesity and insulin resistance-associated disorders.]]></description><subject>Bone Density</subject><subject>Bone mineral density</subject><subject>Calcification, Physiologic</subject><subject>Cancellous bone</subject><subject>Cirrhosis</subject><subject>Colorectal Surgery</subject><subject>Computer architecture</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes mellitus</subject><subject>Dual energy X-ray absorptiometry</subject><subject>Endocrinology</subject><subject>Fatty liver</subject><subject>Fibrosis</subject><subject>Fragility</subject><subject>Health risks</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Insulin-Like Growth Factor I</subject><subject>Insulin-like growth factors</subject><subject>Liver</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic syndrome</subject><subject>Microstructure</subject><subject>Mineralization</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Original Article</subject><subject>Osteocalcin</subject><subject>Osteopenia</subject><subject>Osteoporosis</subject><subject>Osteoporosis - complications</subject><subject>Parathyroid hormone</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Surgery</subject><subject>Vitamin D</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1TAQhiMEojdegAWyxKabwPieLFFFAelIbLq3fEvrKrEPtlNU3qHvjE9TisQCydKMx9_8Y_vvurcYPmAA-bFgApL0QEiPgQnc4xfdMR6p6IEz_PI5p_SoOynlFoBzgcXr7ogKToBKedw97MKdz2gKJqcSCmpLl5Js0NU79DPUGxSWvQ657UyKHi0h-qzn8EvXkCLS0bWSbc01r7au2aMQUTK-HBIX7oJb9Vw2pZhir2ebbtIcLJp0rfdofpzvQvG6-LPu1dRo_-YpnnZXl5-vLr72u-9fvl182vWWSl57LphhEiynDnNMtWF8opoPRLqRjdwzjsETPjgjBQBg0Z5qBuuMpSNjEz3tzjfZfU4_Vl-qWkKxfp519GktikjOBj5yiRv6_h_0Nq05tsspMgADyohgjSIbdfiIkv2k9jksOt8rDOrgldq8Us0r9eiVOki_e5JezeLdc8sfcxpAN6C0o3jt89_Z_5H9DWLAoMA</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Barchetta, Ilaria</creator><creator>Lubrano, Carla</creator><creator>Cimini, Flavia Agata</creator><creator>Dule, Sara</creator><creator>Passarella, Giulia</creator><creator>Dellanno, Arianna</creator><creator>Di Biasio, Alberto</creator><creator>Leonetti, Frida</creator><creator>Silecchia, Gianfranco</creator><creator>Lenzi, Andrea</creator><creator>Cavallo, Maria Gisella</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease</title><author>Barchetta, Ilaria ; Lubrano, Carla ; Cimini, Flavia Agata ; Dule, Sara ; Passarella, Giulia ; Dellanno, Arianna ; Di Biasio, Alberto ; Leonetti, Frida ; Silecchia, Gianfranco ; Lenzi, Andrea ; Cavallo, Maria Gisella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-564b470c53d1513ab45f3a5827d9495e4510e258db7600016377b8cdbc3944f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Bone Density</topic><topic>Bone mineral density</topic><topic>Calcification, Physiologic</topic><topic>Cancellous bone</topic><topic>Cirrhosis</topic><topic>Colorectal Surgery</topic><topic>Computer architecture</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes mellitus</topic><topic>Dual energy X-ray absorptiometry</topic><topic>Endocrinology</topic><topic>Fatty liver</topic><topic>Fibrosis</topic><topic>Fragility</topic><topic>Health risks</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Insulin-Like Growth Factor I</topic><topic>Insulin-like growth factors</topic><topic>Liver</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic syndrome</topic><topic>Microstructure</topic><topic>Mineralization</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Original Article</topic><topic>Osteocalcin</topic><topic>Osteopenia</topic><topic>Osteoporosis</topic><topic>Osteoporosis - complications</topic><topic>Parathyroid hormone</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Surgery</topic><topic>Vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barchetta, Ilaria</creatorcontrib><creatorcontrib>Lubrano, Carla</creatorcontrib><creatorcontrib>Cimini, Flavia Agata</creatorcontrib><creatorcontrib>Dule, Sara</creatorcontrib><creatorcontrib>Passarella, Giulia</creatorcontrib><creatorcontrib>Dellanno, Arianna</creatorcontrib><creatorcontrib>Di Biasio, Alberto</creatorcontrib><creatorcontrib>Leonetti, Frida</creatorcontrib><creatorcontrib>Silecchia, Gianfranco</creatorcontrib><creatorcontrib>Lenzi, Andrea</creatorcontrib><creatorcontrib>Cavallo, Maria Gisella</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barchetta, Ilaria</au><au>Lubrano, Carla</au><au>Cimini, Flavia Agata</au><au>Dule, Sara</au><au>Passarella, Giulia</au><au>Dellanno, Arianna</au><au>Di Biasio, Alberto</au><au>Leonetti, Frida</au><au>Silecchia, Gianfranco</au><au>Lenzi, Andrea</au><au>Cavallo, Maria Gisella</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>17</volume><issue>2</issue><spage>357</spage><epage>366</epage><pages>357-366</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract><![CDATA[Background and purpose
Chronic liver diseases are associated with increased bone fracture risk, mostly in end-stage disease and cirrhosis; besides, data in non-alcoholic fatty liver disease (NAFLD) are limited. Aim of this study was to investigate bone mineralization and microstructure in obese individuals with NAFLD in relation to the estimated liver fibrosis.
Methods
For this cross-sectional investigation, we analyzed data from 1872 obese individuals (44.6 ± 14.1 years, M/F: 389/1483; BMI: 38.3 ± 5.3 kg/m
2
) referring to the Endocrinology outpatient clinics of Sapienza University, Rome, Italy. Participants underwent clinical work-up, Dual-Energy X-ray Absorptiometry for assessing bone mineral density (BMD) and microarchitecture (trabecular bone score, TBS). Liver fibrosis was estimated by Fibrosis Score 4 (FIB-4). Serum parathyroid hormone (PTH), 25(OH) vitamin D, osteocalcin and IGF-1 levels were measured.
Results
Obese individuals with osteopenia/osteoporosis had greater FIB-4 than those with normal BMD (
p
< 0.001). FIB-4 progressively increased in presence of degraded bone microarchitecture (
p
< 0.001) and negatively correlated with the serum osteocalcin (
p
< 0.001) and IGF-1 (
p
< 0.001), which were both reduced in presence of osteopenia/osteoporosis. FIB-4 predicted IGF-1 reduction in multivariable regression models adjusted for confounders (
β
: − 0.18,
p
< 0.001). Higher FIB-4 predicted bone fragility with OR 3.8 (95%C.I:1.5–9.3); this association persisted significant after adjustment for sex, age, BMI, diabetes, smoking status and PTH at the multivariable logistic regression analysis (OR 1.91 (95%C.I:1.15–3.17),
p
< 0.01), with AUROC = 0.842 (95%C.I:0.795–0.890;
p
< 0.001).
Conclusion
Our data indicate the presence of a tight relation between NAFLD-related liver fibrosis, lower bone mineral density and degraded microarchitecture in obese individuals, suggesting potential common pathways underlying liver and bone involvement in obesity and insulin resistance-associated disorders.]]></abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>36520377</pmid><doi>10.1007/s12072-022-10461-1</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-0533 |
| ispartof | Hepatology international, 2023-04, Vol.17 (2), p.357-366 |
| issn | 1936-0533 1936-0541 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2754859571 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Bone Density Bone mineral density Calcification, Physiologic Cancellous bone Cirrhosis Colorectal Surgery Computer architecture Cross-Sectional Studies Diabetes mellitus Dual energy X-ray absorptiometry Endocrinology Fatty liver Fibrosis Fragility Health risks Hepatology Humans Insulin Insulin resistance Insulin-Like Growth Factor I Insulin-like growth factors Liver Liver Cirrhosis - complications Liver diseases Medicine Medicine & Public Health Metabolic syndrome Microstructure Mineralization Non-alcoholic Fatty Liver Disease - complications Obesity Obesity - complications Original Article Osteocalcin Osteopenia Osteoporosis Osteoporosis - complications Parathyroid hormone Regression analysis Regression models Surgery Vitamin D |
| title | Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease |
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