Evidence mapPaperPMID 41524966Full record

ReviewArchives of osteoporosis2026

The contested association between MASLD and osteoporosis: a narrative review of heterogeneous evidence and modifying factors.

Ya-Jun Xiao, Yan-Ling Zhang, Xiao-Zhou Mao, Di Yang, Yan-Qun Liu, Yan Cheng, Xiao-Ling Liu, Chang-Feng Sun, Hao Sun, Cun-Liang Deng

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In one paragraph

Review in Archives of osteoporosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ya-Jun XiaoDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Yan-Ling ZhangDepartment of Nephrology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.
Xiao-Zhou MaoDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Di YangDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Yan-Qun LiuDepartment of Geriatrics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.
Yan ChengDepartment of Geriatrics, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.
Xiao-Ling LiuDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Chang-Feng SunDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Hao SunDepartment of Medical Equipment Management, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China. sunhao2030@126.com.
Cun-Liang DengDepartment of Infectious Diseases, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China. dengcunl@swmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) and osteoporosis are prevalent chronic metabolic disorders. Although a pathophysiological plausibility for their association exists, clinical evidence demonstrates substantial controversy and heterogeneity.

aimsFirst, review and critically evaluate the controversial evidence regarding their association; second, analyze the sources of research heterogeneity, elucidate the regulatory roles of key effect modifiers; and third, integrate shared pathophysiological mechanisms to provide insights for future research and clinical practice.

methodsWe conducted a literature search in PubMed, Embase, Cochrane Library, Scopus, and Web of Science up to September 16, 2025, using relevant keywords and terms.

resultsCurrent studies have reported varying associations between MASLD and bone mineral density, ranging from negative to null to positive. The relationship between MASLD and bone metabolism exhibits highly complex, conditional, and context-dependent characteristics. The strength and direction of this association may be significantly influenced by a range of effect modifiers, including gender, age, ethnicity, visceral fat distribution, the severity of MASLD, and the sites of skeletal measurement. Factors such as chronic inflammatory responses, insulin resistance, and adipokine dysregulation may be involved in modulating this association.

conclusionsThe association between MASLD and osteoporosis is highly complex, conditional, and context-dependent, as its direction and magnitude are significantly modulated by multiple effect modifiers. Future research requires large-scale, long-term, multicenter prospective cohort studies to thoroughly investigate their causal relationship and underlying mechanisms.

Indexed as

Fatty LiverOsteoporosisBone DensityHumansBone mineral densityContested associationHeterogeneous evidenceMetabolic dysfunction-associated steatotic liver diseaseNarrative reviewOsteoporosis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.