Goldscheitter Galen M, Seneshaw Mulugeta, Mirshahi Faridoddin, Buettmann Evan G, Genetos Damian C, Sanyal Arun J, Donahue Henry J
Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
Medical Scientist Training Program, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Sci Rep. 2025 Jul 2;15(1):23090. doi: 10.1038/s41598-025-08693-w.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is highly prevalent with major risk of progression to Metabolic Dysfunction-Associated Steatohepatitis (MASH) and Hepatocellular Carcinoma (HCC). Recently, osteoporosis and bone fracture have emerged as sexually-dimorphic comorbidities of MASLD yet the mechanisms of this bone loss are unknown. Herein, we address these knowledge gaps using DIAMOND mice which develop MASLD, MASH, and HCC via Western diet exposure. We examined the skeletal phenotype of male DIAMOND mice after 16, 36, and 48 weeks of exposure to Western or control diet. At 16 weeks, male DIAMOND mice with MASLD lose trabecular bone but retain mechanical bone integrity. At 48 weeks, males lose cortical bone and mechanical integrity, indicating severe skeletal weakening. Female DIAMOND mice were protected from cortical and trabecular MASLD-associated bone loss and skeletal fragility at all timepoints. Using NicheNet, a publicly available database of hepatic mRNA expression in DIAMOND mice, and a PTH-induced model of bone loss, we suggest Ctgf, Rarres2, Anxa2, Fgf21, and Mmp13 are liver-secreted ligands inducing bone resorption. This study is the first preclinical investigation of bone loss in MASLD, and the first to suggest the role of Ctgf, Rarres2, Anxa2, Fgf21, and Mmp13 as drivers of this pathology.
代谢功能障碍相关脂肪性肝病(MASLD)极为常见,具有进展为代谢功能障碍相关脂肪性肝炎(MASH)和肝细胞癌(HCC)的重大风险。最近,骨质疏松症和骨折已成为MASLD的性别差异共病,但这种骨质流失的机制尚不清楚。在此,我们使用通过西式饮食暴露而发展出MASLD、MASH和HCC的DIAMOND小鼠来填补这些知识空白。我们检查了雄性DIAMOND小鼠在暴露于西式饮食或对照饮食16周、36周和48周后的骨骼表型。在16周时,患有MASLD的雄性DIAMOND小鼠小梁骨丢失,但保持骨骼机械完整性。在48周时,雄性小鼠皮质骨和机械完整性丧失,表明严重的骨骼弱化。在所有时间点,雌性DIAMOND小鼠均免受皮质和小梁骨与MASLD相关的骨丢失及骨骼脆性影响。利用NicheNet(一个公开可用的DIAMOND小鼠肝脏mRNA表达数据库)以及甲状旁腺激素诱导的骨质流失模型,我们认为结缔组织生长因子(Ctgf)、视黄醇结合蛋白2(Rarres2)、膜联蛋白A2(Anxa2)、成纤维细胞生长因子21(Fgf21)和基质金属蛋白酶13(Mmp13)是肝脏分泌的诱导骨吸收的配体。本研究是对MASLD骨质流失的首次临床前研究,也是首次提出Ctgf、Rarres2、Anxa2、Fgf21和Mmp13在这种病理过程中作为驱动因素的作用。
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