Pan Binjing, Zhao Yangting, Chen Chongyang, Cai Jing, Li Kai, Wang Yawen, Liu Jingfang
The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Endocrine. 2024 Jul;85(1):206-221. doi: 10.1007/s12020-024-03724-4. Epub 2024 Feb 17.
To investigate the relationship between advanced liver fibrosis and osteoporosis in metabolic-associated fatty liver disease (MAFLD) in patients with type 2 diabetes mellitus (T2DM).
A total of 1144 T2DM patients were divided into the MAFLD and non-MAFLD groups, 460 T2DM patients with MAFLD (277 males aged ≥50 years and 183 postmenopausal females) were divided into N1 (advanced liver fibrosis excluded), N2 (indeterminate advanced liver fibrosis), and N3 (advanced liver fibrosis) groups according to the non-alcoholic fatty liver fibrosis score (NFS), the differences in bone mineral density (BMD) levels and prevalence of osteoporosis were compared. Based on the tertile levels of BMD of the lumbar spine (L), T2DM patients were divided into three groups (T1, T2, and T3), and the differences in the prevalence of advanced liver fibrosis were compared.
The BMD levels of the L, and L in the MAFLD group were lower than those of the non-MAFLD groups in male and female T2DM patients .The BMD levels of the total hip, L, and L in the N3 group were lower than those of the N2 and N1 groups in male and female T2DM patients with MAFLD, and the prevalence of osteoporosis in the N3 group of males was higher than that in the N1 group. The BMD levels of the total hip, L, and L were negatively correlated with NFS in both males and females. The BMD levels of the total hip and L in males, and the BMD level of L in females were negatively associated with NFS. The prevalence of advanced liver fibrosis was higher in the T1 group than in the T2 and T3 groups in T2DM patients with MAFLD.
The BMD levels in male aged ≥50 years or postmenopausal female diabetic patients with MAFLD were negatively correlated with the degree of advanced liver fibrosis, which means an increased risk of liver fibrosis with decreasing BMD.
探讨2型糖尿病（T2DM）患者代谢相关脂肪性肝病（MAFLD）中晚期肝纤维化与骨质疏松之间的关系。
将1144例T2DM患者分为MAFLD组和非MAFLD组，将460例患有MAFLD的T2DM患者（277例年龄≥50岁的男性和183例绝经后女性）根据非酒精性脂肪性肝纤维化评分（NFS）分为N1（排除晚期肝纤维化）、N2（不确定的晚期肝纤维化）和N3（晚期肝纤维化）组，比较骨密度（BMD）水平和骨质疏松患病率的差异。根据腰椎（L）的BMD三分位数水平，将T2DM患者分为三组（T1、T2和T3），比较晚期肝纤维化患病率的差异。
在男性和女性T2DM患者中，MAFLD组的L和L的BMD水平低于非MAFLD组。在患有MAFLD的男性和女性T2DM患者中，N3组的全髋、L和L的BMD水平低于N2和N1组，且N3组男性的骨质疏松患病率高于N1组。男性和女性的全髋、L和L的BMD水平与NFS均呈负相关。男性的全髋和L的BMD水平以及女性的L的BMD水平与NFS呈负相关。在患有MAFLD的T2DM患者中，T1组的晚期肝纤维化患病率高于T2和T3组。
年龄≥50岁的男性或患有MAFLD的绝经后女性糖尿病患者的BMD水平与晚期肝纤维化程度呈负相关，这意味着随着BMD降低，肝纤维化风险增加。
