Do Ho Jeong, Shin Joon-Shik, Lee Jinho, Lee Yoon Jae, Kim Me-Riong, Nam Dongwoo, Kim Eun-Jung, Park Yeoncheol, Suhr Kristin, Ha In-Hyuk
Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 538 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
BMC Musculoskelet Disord. 2018 Nov 24;19(1):410. doi: 10.1186/s12891-018-2322-1.
Osteoporosis is a major health concern for both men and women, and associated fractures incur substantial economic burden. While there are a multitude of studies on bone mineral density (BMD) and liver diseases, not many studies have assessed the association between liver enzyme levels and BMD in homogeneous populations.
The current study investigated the association between serum liver enzyme levels and BMD at various sites in Koreans. Out of 21,517 surveyees of the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 7160 participants' data on BMD, serum liver enzymes, and full covariate data were included for cross-sectional analysis. BMD at the femoral neck, lumbar spine, entire femur, and whole body was assessed using dual energy X-ray absorptiometry (DEXA), and liver enzymes included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma(γ)-glutamyl transferase (GGT) levels. Differences in participant characteristics by BMD and liver enzyme levels were analyzed, and complex sample design regression analysis adjusted for multiple covariates was performed to assess the relationship between liver enzymes and BMD.
Negative associations were seen with GGT and BMD at all sites (P ≤ 0.02), ALT with lumbar spine (P = 0.0013), and AST with lumbar BMD (P = 0.0009). In particular, GGT presented strong negative associations with BMD in postmenopausal women and elder men.
This study demonstrates a negative relationship between liver enzyme levels and BMD, and suggests that a significant association exists between osteoporosis/decreased BMD and liver disorders.
骨质疏松症是男性和女性共同面临的重大健康问题，与之相关的骨折会带来巨大的经济负担。虽然有大量关于骨密度（BMD）和肝脏疾病的研究，但在同质人群中评估肝酶水平与BMD之间关联的研究并不多。
本研究调查了韩国人血清肝酶水平与不同部位骨密度之间的关联。在第五次韩国全国健康与营养检查调查（2010 - 2012年）的21517名受访者中，纳入了7160名参与者的骨密度、血清肝酶及全协变量数据进行横断面分析。使用双能X线吸收法（DEXA）评估股骨颈、腰椎、全股骨和全身的骨密度，肝酶包括天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）水平。分析了按骨密度和肝酶水平划分的参与者特征差异，并进行了调整多个协变量的复杂样本设计回归分析，以评估肝酶与骨密度之间的关系。
在所有部位均观察到GGT与骨密度呈负相关（P≤0.02），ALT与腰椎骨密度呈负相关（P = 0.0013），AST与腰椎骨密度呈负相关（P = 0.0009）。特别是，GGT在绝经后女性和老年男性中与骨密度呈现出强烈的负相关。
本研究表明肝酶水平与骨密度之间存在负相关关系，并提示骨质疏松症/骨密度降低与肝脏疾病之间存在显著关联。
