Metabolic dysfunction-associated steatotic liver disease is associated with higher bone mineral density: results from...

We used data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and bone mineral density (BMD) among U.S. adults. Our findings indicated that participants with MASLD had higher BMD than those without MASLD.

Given the stigma associated with the term "NAFLD," experts participating in a Delphi consensus proposed renaming the condition "MASLD". Nevertheless, the association between MASLD and BMD remains unclear. This study aimed to investigate the relationship between MASLD and BMD.

A cross-sectional study was conducted among 6470 participants aged 18 years or older using data from the 2005 to 2010, 2013 to 2014, and 2017 to 2018 cycles of the NHANES. MASLD was defined according to diagnostic criteria established through a Delphi consensus. Multivariable linear regression analyses were performed to evaluate the associations of MASLD with femoral neck and total femur BMD, while logistic regression analysis was used to investigate the association between MASLD and osteoporosis.

Among the 6470 participants, the mean age was 53.16 ± 17.27 years, 49.54% were male, and 23.52% met the criteria for MASLD. After multivariable adjustment, participants with MASLD had higher femoral neck BMD (β = 0.0238; 95% CI, 0.0154-0.0321) and total femur BMD (β = 0.0332; 95% CI, 0.0244-0.0419) than those without MASLD. In subgroup analyses, participants with individual cardiometabolic components of MASLD, including BMI ≥ 25 kg/m², diabetes, hypertension, and hyperlipidemia, also exhibited higher femoral BMD after multivariable adjustment. Moreover, multivariable logistic regression analysis indicated that MASLD was significantly associated with lower odds of osteoporosis.

Our findings suggest that participants with MASLD have higher BMD compared to those without MASLD.