ArticleArchives of osteoporosis2025
Nonalcoholic fatty liver disease may increase the risk of osteoporosis in middle aged adults: a 12-year longitudinal analysis from the Korean Genome and Epidemiology Study (KoGES).
Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Baseline nonalcoholic fatty liver disease and future osteoporosis risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
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Abstract
This study examined whether fatty liver increases the risk of osteoporosis. Over 12 years, people with nonalcoholic fatty liver disease had a significantly higher risk of developing osteoporosis. These findings highlight the importance of bone health monitoring in middle-aged adults with fatty liver.
backgroundOsteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in increased bone fragility and fracture risk. Recent studies have suggested a potential association between nonalcoholic fatty liver disease (NAFLD) and osteoporosis; however, findings have been inconsistent. The aim of this study was to investigate the longitudinal association between NAFLD and osteoporosis in a middle-aged Korean population.
methodsA total of 5,149 individuals (2,386 men and 2,763 women) aged 40-60 years were included in the Korean Genome and Epidemiology Study, after excluding those with liver disease, heavy alcohol consumption, or osteoporosis at baseline. Osteoporosis was defined as a T-score ≤ -2.5 at any site, and normal bone density as a T-score ≥ -1.0, based on World Health Organization criteria. Participants were categorized into three groups according to their fatty liver index (FLI): non-NAFLD (< 30), intermediate (30-59), and NAFLD (≥ 60). Multivariable Cox proportional hazards regression was used to assess the risk of osteoporosis across FLI categories. Propensity score (PS) matching was performed to further assess the association between NAFLD and osteoporosis.
resultsOver a 12-years follow-up, the incidence of osteoporosis was 10.52% in the non-NAFLD group, 13.79% in the intermediate group, and 13.03% in the NAFLD groups, showing a significant linear trend (p for trend = 0.002). After adjusting for potential confounders, the hazard ratios (95% confidence interval) were 1.36 (1.09-1.70) in the intermediate group and 1.80 (1.30-2.49) in the NAFLD group, compared with the non-NAFLD group. In postmenopausal women, the association between NAFLD and increased risk of osteoporosis remained significant after adjusting for confounders. Furthermore, among the PS-matched participants (449 pairs), the NAFLD group showed a significantly higher risk of osteoporosis than the non-NAFLD group.
conclusionNAFLD was independently associated with an increased risk of developing osteoporosis. These findings suggest that osteoporosis screening may be warranted in middle-aged adults with NAFLD.
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