Comorbid flow non-alcoholic fatty liver disease and osteoporosis

SUMMARY

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. Its comorbid course with various diseases is noted. It has been established that bone disorders are often detected in NAFLD.

The purpose of the study. To clarify the effect of NAFLD on the condition of bone tissue, the dependence of changes in BMD and the severity of the pathological process in the liver.

Materials and methods. 98 women were examined, with an average age of 53.3±6.24 years. All individuals underwent a clinical examination, body mass index was calculated, ultrasound examination (ultrasound) of the abdominal cavity, two-energy X-ray absorptimetry of the lumbar spine (LS) and femoral neck (FN) with clarification of the value of the T-criterion, esophagogastroduodenoscopy, biochemical blood analysis were performed. All patients were divided into 3 groups: the first group consisted of 47 people with liver steatosis, the second group included 25 people with steatohepatitis. The control group included 26 women with the results of biochemical blood parameters within the reference values and unchanged liver ultrasound data. Results. The analysis of clinical symptoms showed the presence of asthenic syndrome/chronic fatigue in all patients with NAFLD, while the severity of symptoms increased with steatohepatitis. According to densitometry, the average values of the T-criterion in both SB and POP did not significantly differ in patients with liver steatosis and the control group. In patients with steatohepatitis, there was a significant decrease in the T-criterion in both study areas. The prevalence of osteoporosis (OP) and osteopenia in the first and control groups did not differ statistically. In steatohepatitis, OP was detected twice as often as in liver steatosis.

Conclusions. The presented data indicate that asthenic syndrome dominates the clinical picture of NAFLD. The results of the study confirm the comorbid course of NAFLD at the stage of steatohepatitis and OP.

1. Povsic M., Wong O. Y., Perry R. et/ all/ Structured Literature Review of the Epidemiology and Disease Burden of NonAlcoholic Steatohepatitis (NASH). Adv Ther. 2019; 36(7):1574–94. DOI:10.1007/s12325-019-00960-3

2. Basaranoglu M., Neuschwander-Tetri B. A. Nonalcoholic Fatty Liver Disease: Clinical Features and Pathogenesis. Gastroenterol Hepatol. 2006; 2(4): 282–291. PMID: 28286458; PMCID: PMC 5335683.

3. Tsukanov V. V., Osipenko M. F., Beloborodova E. V. et al. Practical Aspects of Clinical Manifestations, Pathogenesis and Therapy of Alcoholic Liver Disease and Non-alcoholic Fatty Liver Disease: Expert Opinion. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2023;33(4):7–13. https://doi.org/10.22416/1382-4376-2023-33-4-7-13

4. Jichitu A., Bungau S., Stanescu A. M.A. et al. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management. Diagnostics (Basel). 2021;11(4): 689. DOI:10.3390/diagnostics11040689

5. Birkenfeld A. L., Shulman G. I. Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes. Hepatology. 2014;59:713–23. DOI: 10.1002/hep.26672

6. Targher G., Byrne C. D. Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease. Nat Rev Nephrol. 2017;13:297–310.DOI:10.1038/nrneph.2017.16

7. Livzan M. A., Gaus O. V., Nikolaev N. A. et al. NAFLD: comorbidity and associated diseases. Experimental and Clinical Gastroenterology. 2019;1(10):57–65. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-170-10-57-65

8. Salikhova S. B., Karimov M. M., Sobirova G. N. et al. Parameters of bone mineral density in non-alcoholic fatty liver disease. Bulletin of the doctor. 2014;3:182–184. (In Russ.)

9. Ocheretina R. Y. The relationship of the morphofunctional state of the liver with bone metabolism. The successes of modern natural science. 2015;2:89–93. (In Russ.)

10. Chen HJ, Yang HY, Hsueh KC, et al. Increased risk of osteoporosis in patients with nonalcoholic fatty liver disease: A population-based retrospective cohort study. Medicine (Baltimore). 2018;97(42): e12835. DOI:10.1097/MD.0000000000012835

11. Belaya Zh.E., Rozhinskaya L. Y., Grebennikova T. A. et al. Summary of the draft federal clinical guidelines for osteoporosis. Osteoporosis and Bone Diseases. 2020;23(2):4–21. (In Russ.)

12. Kazakova VS, Novikov ОО, Zhilyakova EТ, et al. Рrospects for the use of growth factors in bone tissue regeneration. Literature review. Research Result. Medicine and Pharmacy Series. 2015;1(3):151–158 (In Russ)]. DOI: 10.18413/2313-8955-2015-1-3-151-158

13. ИIgnatenko G.A., Nemsadze I.G., Mirovich E.D. et al. The role of cytokines in bone remodeling and the pathogenesis of postmenopausal osteoporosis. Medical Herald of the South of Russia. 2020;11(2):6–18. (In Russ.) doi.org/10.21886/2219-8075-2020-11-2-6-18

14. Yuchen T., Shenghong W., Qiong Yi, et al. High-density Lipoprotein Cholesterol Is сorrelated with bone mineral density and has potential predictive value for bone loss. Lipids in Health and Disease. 2021; 20:75 doi.org/10.1186/s12944-021-01497-7

15. lyushchenko A.K., Machekhina L. V., Strazhesko I. D. et al. The role of IGF-1/GH in the aging process and the development of age-related diseases. Obesity and metabolism. 2023;20(2):149–157. (In Russ.) https://doi.org/10.14341/omet12934

16. Yuan S, Wan ZH, Cheng SL et al. Insulin-like Growth Factor-1, Bone Mineral Density, and Fracture: A Mendelian Randomization Study. J Clin Endocrinol Metab 2021; 106(4): e1552-e1558. doi: 10.1210/clinem/dgaa963.

17. Reinehr T., Woelfle J., Wunsch R. et al. Fibroblast growth factor 21 (FGF-21) and its relation to obesity, metabolic syndrome, and nonalcoholic fatty liver in children: A longitudinal analysis. The Journal of Clinical Endocrinology and Metabolism. 2012;97(6):2143–2150. doi: 10.1210/jc.2012-1221.

18. Florén CH, Chen CH, Franzén J. et al. Lecithin: cholesterol acyltransferase in liver disease.. Scand J Clin Lab Invest 1987; 47(6):613–7. doi: 10.1080/00365518709168477.

19. Nardo A. D., Grun N. G., Zeyda M.et all Impact of osteopontin on the development of nonalcogolic liver disease and related hepatocellular carcinoma Liver Int. 2020; 40 (7): 1620–1633ю doi: 10.1111\liv.14464

20. Yilmaz Y, Yonal O, Kurt R. et al. Serum levels of osteoprotegerin in the spectrum of nonalcoholic fatty liver disease. Scand J Clin Lab Invest. 2010;70(8):541–6. doi: 10.3109/00365513.2010.524933.

21. Moser S. C., van der Eerden. Osteocalcin – A Versatile Bone-Derived Hormone Citation: BCJ. Endocrinol. 2019;9:794. doi: 10.3389/fendo.2018.00794

22. Otani T., Mizocami A., Kawakudo-Yasukochi T et al. The roles of osteocalcin in lipid metabolism in adipose tissue and liver Adv. Biol. Rehul. 2020;78:100762 doi 10.1016\j.jbior.2020.100762

23. Ruhi K., Saif Q., Haque S. F. et al. TNF-α is an Inflammatory Marker of Cardiovascular Risks in Non-Alcoholic Fatty Liver Disease. J Clin Diagn Res. 2011;5(6):1237–1240. DOI: 10.7860/JCDR/2011/.1621.

24. Ilias D., Vachliotis М., Stergios A. The Role of Tumor Necrosis Factor-Alpha in the Pathogenesis and Treatment of Nonalcoholic Fatty Liver Disease. Curr Obes Rep. 2023; 12(3):191–206. doi: 10.1007/s13679-023-00519.

25. Yao Z., Stephen J. Getting J. et al. Regulation of TNF-Induced Osteoclast Differentiation. Cells. 2022;11(1):132. DOI: 10.3390/cells11010132

26. Topolyanskaya S. V. Tumor Necrosis Factor-Alpha and Age-Related Pathologies. The Russian Archives of Internal Medicine. 2020;10(6): 414–421. DOI: 10.20514/2226-6704-202 0-10-6-414-421.

27. Maltsev S. V. Modern data on vitamin D – metabolism, role in the organism, and features of application in a doctor’s practice. Practical medicine. 2020; 18(4): 8–22. (in Russ). DOI: 10.32000/2072-1757-2020-4-8-22

28. Targher G, Bertolini L, Scala L, et al. Associations between serum 25-hydroxyvitamin D 3 concentrations and liver histology in patients with nonalcoholic fatty liver disease. Nutr Metab Cardiovasc Dis. 2007;17:517–24. DOI: 10.1016/j.numecd.2006.04.002

29. Gad A. I., Elmedames M. R., Abdelhai A. R. et al. The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study. Egyptian Liver Journal 2020;10:25–31 doi.org/10.1186/s43066-020-00033-z

30. Kuznetsova E. A., Esaulenko E. E., Bykov I. M. Biochemical mechanisms of testosterone deficiency in men with non-alcoholic fatty liver disease. Crimean Journal of Experimental and Clinical Medicine. 2021;11(4):98–105 DOI: 10.37279/2224-6444-2021-11-4-98-105

31. Fink H. A., Ewing S. K., Ensrud K. E. et al. Association of testosterone and estradiol deficiency with osteoporosis and rapid bone loss in older men. J Clin Endocrinol Metab. 2006; 91(10): 3908–15. doi: 10.1210/ jc.2006–0173.

32. Galchenko AV. Influence of lifestyle factors on bone metabolism and the risk of osteoporosis. Russian Journal of Preventive Medicine. 2022;25(6):96–107. (In Russ.) doi.org/10.17116/profmed20222506196.

33. Rosato V, Masarone M, Dallio M, et al. NAFLD and Extra-Hepatic Comorbidities: Current Evidence on a Multi-Organ Metabolic Syndrome. Int J Environ Res Public Health. 2019;16(18):3415. DOI: 10.3390/ijerph16183415).

34. Filip R, Radzki RP, Bieńko M. Novel insights into the relationship between nonalcoholic fatty liver disease and osteoporosis. Clin Interv Aging. 2018;13:1879–91. DOI: 10.2147/CIA.S 170533

35. Fomina L. A., Zyabreva I. A. Gender aspects of osteoporosis and their relationship to calcium balance. Kazan medical journal. 2017; 98(3): 343–348. (in Russ). doi: 10.17750/KMJ2017-343