Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short-Bowel Syndrome

Osteoporosis has scarcely been prospectively investigated in short-bowel syndrome (SBS). This prospective study was designed to evaluate incretins, adipokines, bone mass, and lipid deposits from marrow adipose tissue (MAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver (IHLs).

The study comprised 2 groups matched by gender, height, and age: the control group (CG) (9 males, 9 females) and the SBS group (SBSG) (6 males, 5 females). The SBSG was evaluated twice in an interval of 1 year (SBSG₀ and SBSG₁ ). The biochemical evaluation included incretins, leptin, and adiponectin. Dual-energy x-ray absorptiometry and magnetic resonance were, respectively, used to measure BMD and lipid deposits.

Bone mineral density (BMD) was lower in the SBSG than in the CG, but there was no difference between SBSG₀ and SBSG₁ . There was no difference in MAT, SAT, and VAT, but IHL was lower in CG than in SBSG₀ and SBSG₁ . A negative correlation between MAT and third lumbar vertebrae BMD was found in the CG but not in SBSG₀ or SBSG₁ . There was a negative association between IHL and bone mass considering all participants (CG and SBSG₀ ) (R² = 0.38; P < .05).

Appropriate nutrition assistance recovers body composition, reverts the relationship of bone mass and MAT, and mitigates bone loss in SBS. In spite of this, osteoporosis seems to be an early and persistent complication in SBS. Curiously, SBS seems to be a highly vulnerable condition for the development of hepatic steatosis and shows an association between bone mass and IHL.