title: Increased bone mineral density in patients with non-alcoholic steatohepatitis.
abstract: OBJECTIVE
  To determine the relationship between non-alcoholic steatohepatitis (NASH) and bone mineral density (BMD).
  
  
  METHODS
  A total of 38 patients (25 males) with a diagnosis of histologically proven NASH and 42 healthy controls (24 males) were enrolled in the study. Demographic features, clinical findings, complete blood count and routine biochemical analysis, as well as adrenal, thyroid and gonadal functions, were recorded. Additionally, intact parathormone, 25-OH-vitamin-D3, tumor necrosis factor-α, interleukin-6, interleukin-1, insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels were measured in both groups. Furthermore, lumbar spine and femoral neck BMD of both groups were measured by the dual-energy X-ray absorptiometry (DXA) method.
  
  
  RESULTS
  The mean age was 41 ± 12 years in the NASH group and 43 ± 11 years in the control group. Among demographic features, waist circumference was significantly larger in the NASH group compared to the control group (P < 0.019). Among laboratory parameters, serum triglyceride (P < 0.008), alanine transaminase (P < 0.0001), aspartate transaminase (P < 0.001), alkaline phosphatase (P < 0.016), gamma glutamyl transferase (P < 0.0001), ferritin (P < 0.001) and 25-OH-vitamin-D3 levels (P < 0.0001) were significantly higher in the NASH group compared to the control group. Lumbar BMD was significantly higher in the NASH group compared to the control group (1.057 ± 0.119 g/cm(2) vs 0.941 ± 0.133 g/cm(2); P < 0.001, respectively). In the NASH group, there was no significant relationship between BMD and fibrosis stage in liver biopsy.
  
  
  CONCLUSIONS
  NASH increases BMD and may be related to an elevated serum 25-OH-vitamin D3 level.
authors.affiliation: Muhsin Kaya, Remzi Beştaş, Department of Gastroenterology, Dicle University, School of Medicine, Diyarbakır 21100, Turkey.
authors.forename: Muhsin
authors.initials: M
authors.lastname: Kaya
authors.forename: Devran
authors.initials: D
authors.lastname: Işık
authors.forename: Remzi
authors.initials: R
authors.lastname: Beştaş
authors.forename: Osman
authors.initials: O
authors.lastname: Evliyaoğlu
authors.forename: Veysi
authors.initials: V
authors.lastname: Akpolat
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Büyükbayram
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaplan
keywords: Bone mineral density; Hepatic osteodystrophy; Non-alcoholic steatohepatitis