Journal of Endocrinological Investigation

, Volume 39, Issue 11, pp 1329–1336 | Cite as

Association between bone mineral density and nonalcoholic fatty liver disease in Korean adults

  • S. H. Lee
  • J. M. Yun
  • S. H. Kim
  • Y. G. Seo
  • H. Min
  • E. Chung
  • Y. S. Bae
  • I. S. Ryou
  • B. ChoEmail author
Original Article



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.


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.


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).


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.


Nonalcoholic fatty liver disease Osteoporosis Bone mineral density Metabolic syndrome 


Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants (that were performed by any of the authors of this article) were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

No informed consent.

Supplementary material

40618_2016_528_MOESM1_ESM.docx (60 kb)
Supplementary material 1 (DOCX 60 kb)


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Copyright information

© Italian Society of Endocrinology (SIE) 2016

Authors and Affiliations

  • S. H. Lee
    • 1
  • J. M. Yun
    • 1
  • S. H. Kim
    • 1
  • Y. G. Seo
    • 1
  • H. Min
    • 1
  • E. Chung
    • 1
  • Y. S. Bae
    • 1
  • I. S. Ryou
    • 1
  • B. Cho
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivorSeoul National University HospitalSeoulRepublic of Korea
  2. 2.Advanced Institutes of Convergence TechnologySeoul National UniversitySuwon-siRepublic of Korea
  3. 3.Institute on AgingSeoul National University College of MedicineSeoulRepublic of Korea

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