Department of Endocrinology & Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
Int J Endocrinol. 2013;2013:396545. doi: 10.1155/2013/396545. Epub 2013 Jul 31.
Aim. To investigate bone metabolic characteristics in Chinese adults with nonalcoholic fatty liver disease (NAFLD). Methods. A total of 224 patients (99 males and 125 postmenopausal females) were recruited and divided into 4 groups: males without NAFLD, males with NAFLD, females without NAFLD, and females with NAFLD. Bone mineral density (BMD) was evaluated according to body mass index (BMI), waist circumference (WC), and serum biomarkers. β cell function was evaluated by HOMA2%B, HOMA2%S, and HOMA2IR. Results. Males in the NAFLD group had lower BMD of the right hip and the femoral neck (0.852 ± 0.117 versus 0.930 ± 0.123, P = 0.002; 0.736 ± 0.119 versus 0.812 ± 0.132, P = 0.004), and females had lower BMD of the right hip (0.725 ± 0.141 versus 0.805 ± 0.145, P = 0.002) even after adjusted for weight, BMI, waist, HDL, and ALT. There was no significant difference in bone metabolic markers between patients with and without NAFLD. NAFLD was an important factor that affected the bone; moreover, the effect attenuated when HOMA2IR entered into the model (R (2) = 0.160, β = -0.172, and P = 0.008). Conclusions. NAFLD exerts a detrimental effect on BMD in both males and females. Insulin resistance may play an important role in this pathophysiological process.
目的。研究非酒精性脂肪性肝病（NAFLD）中国成年人的骨骼代谢特征。方法。共招募了 224 名患者（99 名男性和 125 名绝经后女性），并将其分为 4 组：无 NAFLD 的男性、有 NAFLD 的男性、无 NAFLD 的女性和有 NAFLD 的女性。根据体重指数（BMI）、腰围（WC）和血清生物标志物评估骨密度（BMD）。通过 HOMA2%B、HOMA2%S 和 HOMA2IR 评估β细胞功能。结果。NAFLD 组男性右侧髋部和股骨颈的 BMD 较低（0.852 ± 0.117 比 0.930 ± 0.123，P = 0.002；0.736 ± 0.119 比 0.812 ± 0.132，P = 0.004），女性右侧髋部的 BMD 也较低（0.725 ± 0.141 比 0.805 ± 0.145，P = 0.002），即使在调整体重、BMI、腰围、HDL 和 ALT 后也是如此。有和无 NAFLD 的患者之间在骨代谢标志物方面没有显著差异。NAFLD 是影响骨骼的重要因素；此外，当 HOMA2IR 进入模型时，这种影响会减弱（R (2) = 0.160，β = -0.172，P = 0.008）。结论。NAFLD 对男性和女性的 BMD 都有不利影响。胰岛素抵抗可能在这个病理生理过程中发挥重要作用。
