title: Association between bone mineral density and nonalcoholic fatty liver disease in Korean adults.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) is associated with various metabolic abnormalities that can increase the risk of an osteoporotic fracture. Across the few previous studies of the association between NAFLD and bone mineral density (BMD), the association was not consistent. We examined the association between BMD and NAFLD in generally healthy adults.
  
  
  METHODS
  The subjects who visited the Seoul National University Hospital for health checkup between 2005 and 2015 were included. Men aged more than 40 and postmenopausal women were included. Lumbar spine and femoral neck (FN) BMD were measured using dual-energy X-ray absorptiometry. Liver ultrasonography was conducted to evaluate the extent of fatty changes. After excluding subjects with a secondary cause of liver disease such as heavy drinking or viral hepatitis, multivariable linear regression analysis adjusted for possible cofactors was performed to investigate the association between BMD and NAFLD.
  
  
  RESULTS
  A total of 6634 subjects was included in this study (men:women = 3306:3328). Multivariate regression analysis revealed a significant negative association between FN BMD and NAFLD in men (β = -0.013, p = 0.029). However, there was a positive correlation between lumbar spine BMD and NAFLD in postmenopausal women (β = 0.022, p = 0.005).
  
  
  CONCLUSIONS
  Moderate or severe NAFLD exerted a detrimental effect on FN BMD in men. However, moderate or severe NAFLD had a positive effect on lumbar spine BMD in postmenopausal women. Potential sex-specific differences of the effect of NAFLD on BMD need to be elucidated further.
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: S H
authors: SH
authors: Lee
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: J M
authors: JM
authors: Yun
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: S H
authors: SH
authors: Kim
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: Y G
authors: YG
authors: Seo
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: H
authors: H
authors: Min
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: E
authors: E
authors: Chung
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: Y S
authors: YS
authors: Bae
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.
authors: I S
authors: IS
authors: Ryou
authors: Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. belong.cho@gmail.com.|Advanced Institutes of Convergence Technology, Seoul National University, 145 Gwanggyo-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 443-270, Republic of Korea. belong.cho@gmail.com.|Institute on Aging, Seoul National University College of Medicine, 71 Ihwajang-Gil, Jongno-gu, Seoul, 110-810, Republic of Korea. belong.cho@gmail.com.
authors: B
authors: B
authors: Cho
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D010024:Osteoporosis / Q000150:complications* / Q000378:metabolism; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers
keywords: Bone mineral density; Metabolic syndrome; Nonalcoholic fatty liver disease; Osteoporosis