Optimal Body Mass Index for Protecting Middle-aged and Elderly Patients with Fatty Liver from Future Fractures

Overview

Journal Endocr Connect

Specialty Endocrinology

Date 2024 May 31

PMID 38819306

Authors

Hsiao-Yun Yeh

Hung-Ta Hondar Wu

Hsiao-Chin Shen

Tzu-Hao Li

Ying-Ying Yang

Kuei-Chuan Lee

Yi-Hsuan Lin

Chia-Chang Huang

Ming-Chih Hou

Affiliations

Soon will be listed here.

Abstract

Objective: Previous studies have suggested that body mass index (BMI) should be considered when assessing the relationship between fatty liver (FL) and osteoporosis. The aim of this study was to investigate future fracture events in people with FL, focusing on the effect of BMI in both sexes.

Methods: This retrospective cohort study from 2011 to 2019 enrolled 941 people, including 441 women and 500 men, aged 50 years or older who underwent liver imaging (ultrasound, computed tomography, or magnetic resonance image) and dual-energy X-ray absorptiometry (DXA, for bone mineral density measurements). The study examined predictors of osteoporosis in both sexes, and the effect of different ranges of BMI (18.5-24, 24-27, and ≥27 kg/m2 in women; 18.5-24, 24-27, 27-30 and ≥30 kg/m2 in men) on the risk of future fractures in FL patients.

Results: The average follow-up period was 5.3 years for women and 4.2 years for men. Multivariate analysis identified age and BMI as independent risk factors for osteoporosis in both sexes. Each unit increase in BMI decreased the risk of osteoporosis by ≥10%. In both women and men with FL, a BMI of 24-27 kg/m2 offered protection against future fractures, compared to those without FL and with a BMI of 18.5-24 kg/m2.

Conclusion: The protective effect of a higher BMI against future fractures in middle-aged and elderly women and men with FL is not uniform and decreases beyond certain BMI ranges.

References

Polyzos S, Kountouras J, Mantzoros C . Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism. 2018; 92:82-97. DOI: 10.1016/j.metabol.2018.11.014. View

Fawzy T, Muttappallymyalil J, Sreedharan J, Ahmed A, Alshamsi S, Al Ali M . Association between Body Mass Index and Bone Mineral Density in Patients Referred for Dual-Energy X-Ray Absorptiometry Scan in Ajman, UAE. J Osteoporos. 2011; 2011:876309. PMC: 3135277. DOI: 10.4061/2011/876309. View

Hariri A, Almatrafi M, Zamka A, Babaker A, Fallatah T, Althouwaibi O . Relationship between Body Mass Index and -Scores of Bone Mineral Density in the Hip and Spine Regions among Older Adults with Diabetes: A Retrospective Review. J Obes. 2019; 2019:9827403. PMC: 6501245. DOI: 10.1155/2019/9827403. View

Rosato V, Masarone M, Dallio M, Federico A, Aglitti A, Persico M . NAFLD and Extra-Hepatic Comorbidities: Current Evidence on a Multi-Organ Metabolic Syndrome. Int J Environ Res Public Health. 2019; 16(18). PMC: 6765902. DOI: 10.3390/ijerph16183415. View

Wu S, Du X . Body Mass Index May Positively Correlate with Bone Mineral Density of Lumbar Vertebra and Femoral Neck in Postmenopausal Females. Med Sci Monit. 2016; 22:145-51. PMC: 4716713. DOI: 10.12659/msm.895512. View

Chen H, Yang H, Hsueh K, Shen C, Chen R, Yu H . Increased risk of osteoporosis in patients with nonalcoholic fatty liver disease: A population-based retrospective cohort study. Medicine (Baltimore). 2018; 97(42):e12835. PMC: 6211874. DOI: 10.1097/MD.0000000000012835. View

De Laet C, Kanis J, Oden A, Johanson H, Johnell O, Delmas P . Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005; 16(11):1330-8. DOI: 10.1007/s00198-005-1863-y. View

Barrera G, Bunout D, Gattas V, de la Maza M, Leiva L, Hirsch S . A high body mass index protects against femoral neck osteoporosis in healthy elderly subjects. Nutrition. 2004; 20(9):769-71. DOI: 10.1016/j.nut.2004.05.014. View

Kan B, Zhao Q, Wang L, Xue S, Cai H, Yang S . Association between lipid biomarkers and osteoporosis: a cross-sectional study. BMC Musculoskelet Disord. 2021; 22(1):759. PMC: 8419899. DOI: 10.1186/s12891-021-04643-5. View

10.

Kanis J, Melton 3rd L, Christiansen C, JOHNSTON C, Khaltaev N . The diagnosis of osteoporosis. J Bone Miner Res. 1994; 9(8):1137-41. DOI: 10.1002/jbmr.5650090802. View

11.

Skrzek A, Koziel S, Ignasiak Z . The optimal value of BMI for the lowest risk of osteoporosis in postmenopausal women aged 40-88 years. Homo. 2014; 65(3):232-9. DOI: 10.1016/j.jchb.2014.01.003. View

12.

Jiao H, Xiao E, Graves D . Diabetes and Its Effect on Bone and Fracture Healing. Curr Osteoporos Rep. 2015; 13(5):327-35. PMC: 4692363. DOI: 10.1007/s11914-015-0286-8. View

13.

Cosman F, de Beur S, LeBoff M, Lewiecki E, Tanner B, Randall S . Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014; 25(10):2359-81. PMC: 4176573. DOI: 10.1007/s00198-014-2794-2. View

14.

Riazi K, Azhari H, Charette J, Underwood F, King J, Afshar E . The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022; 7(9):851-861. DOI: 10.1016/S2468-1253(22)00165-0. View

15.

Compston J, Flahive J, Hosmer D, Watts N, Siris E, Silverman S . Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). J Bone Miner Res. 2013; 29(2):487-93. PMC: 4878680. DOI: 10.1002/jbmr.2051. View

16.

Du J, Ma Y, Lang H, Huang C, Zhang X . The association of nonalcoholic fatty liver disease with bone mineral density in type 2 diabetes. Eur J Med Res. 2022; 27(1):143. PMC: 9358869. DOI: 10.1186/s40001-022-00775-z. View

17.

Targher G, Lonardo A, Rossini M . Nonalcoholic fatty liver disease and decreased bone mineral density: is there a link?. J Endocrinol Invest. 2015; 38(8):817-25. DOI: 10.1007/s40618-015-0315-6. View

18.

Ha J, Baek K . Body mass index at the crossroads of osteoporosis and type 2 diabetes. Korean J Intern Med. 2020; 35(6):1333-1335. PMC: 7652647. DOI: 10.3904/kjim.2020.540. View

19.

Cawthon P . Gender differences in osteoporosis and fractures. Clin Orthop Relat Res. 2011; 469(7):1900-5. PMC: 3111766. DOI: 10.1007/s11999-011-1780-7. View

20.

Chen Y, Li H, Li S, Xu Z, Tian S, Wu J . Prevalence of and risk factors for metabolic associated fatty liver disease in an urban population in China: a cross-sectional comparative study. BMC Gastroenterol. 2021; 21(1):212. PMC: 8111711. DOI: 10.1186/s12876-021-01782-w. View