title: Association between nonalcoholic fatty liver disease (NAFLD) and osteoporotic fracture in middle-aged and elderly Chinese.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) has been considered as a hepatic manifestation of the metabolic syndrome and is associated with various metabolic abnormalities, which may link to an increased risk of osteoporotic fracture. However, epidemiological studies investigating the association between NAFLD and osteoporotic fracture were not available.
  
  
  OBJECTIVE
  The objective of the study was to determine whether NAFLD associates with osteoporotic fracture.
  
  
  METHODS
  This was a cross-sectional study of 7797 Chinese adults aged 40 yr or older in the Jiading District, Shanghai, China.
  
  
  METHODS
  A questionnaire, anthropometric measurements, laboratory tests, and a hepatic ultrasonic examination were conducted. NAFLD was diagnosed by hepatic ultrasound after the exclusion of alcohol abuse and other liver diseases. A history of fractures was collected with an interviewer-assisted questionnaire. Osteoporotic fractures were defined as fractures that occurred due to low-trauma in 2 yr prior to the study.
  
  
  RESULTS
  Among men, the prevalence of osteoporotic fractures was significantly higher in those with NAFLD (3.6 vs. 1.7%, P = 0.003); however, no difference was found in women (3.4 vs. 2.6%, P = 0.14). The presence of NAFLD was significantly associated with increased odds of osteoporotic fracture among men (odds ratio 2.53; 95% confidence interval 1.26-5.07; P = 0.009) after controlling for potential confounders. The significant associations were not detected in women.
  
  
  CONCLUSIONS
  The presence of NAFLD was significantly associated with a recent history of osteoporotic fracture in middle-aged and elderly Chinese men.
authors.affiliation: Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Rui-Jin Second Road, Shanghai 200025, China.
authors.forename: Mian
authors.initials: M
authors.lastname: Li
authors.forename: Yu
authors.initials: Y
authors.lastname: Xu
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Lingying
authors.initials: L
authors.lastname: Ma
authors.forename: Tiange
authors.initials: T
authors.lastname: Wang
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Meng
authors.initials: M
authors.lastname: Dai
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Chen
authors.forename: Jieli
authors.initials: J
authors.lastname: Lu
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.forename: Yufang
authors.initials: Y
authors.lastname: Bi
authors.forename: Guang
authors.initials: G
authors.lastname: Ning
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution