Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents with obesity: a meta-analysis

Figures & data

Table 1 Main characteristics of included studies and quality assessment score

Author	Year	Region	Study type	Diagnosis	Number		Age (y)		BMI (kg/m^2)		BMD (g/cm^2)		BMC (g)		Z-score		NOS
					Case	Control	Case	Control	Case	Control	Case	Control	Case	Control	Case	Control
Pacifico et al^Citation57	2013	Italy	Case–control	MRI	44	44	12.5±1.8	12.5±1.8	NA	NA	NA	NA	NA	NA	1.55±1.02	1.95±0.71	8
Labayen et al^Citation58	2018	Spain	Case–control	MRI	41	74	10.5±1.1	10.6±1.1	26.2±3.3	25.0±3.2	0.89±0.05	0.93±0.06	1308±196	1369±246	0.94±1.07	1.39±0.94	9
Moscal et al^Citation59	2018	Italy	Case–control	Ultrasound liver biopsy	25	9	12.6±2.6	13.2±3.2	28.0±4.3	28.2±3.6	0.87±0.06	0.97±0.12	1740.7± 459	1714.3± 370	0.8±1.0	1.4±1.2	8
Campos et al^Citation60	2012	Brazil	Case–control	Ultrasound	18	22	NA	NA	39.9 ± 5.1	35.8 ± 5.3	1.2±0.1	1.2±0.1	2767.0± 498.3	2835.6± 371.2	1.5±1.0	1.6±1.0	8
Pirgon et al^Citation61	2011	Turkey	Case–control	Ultrasound	42	40	12.5±1.87	12.1±1.34	NA	NA	1.03±0.14	1.03±0.1	NA	NA	0.56±0.3	1.02±0.9	8
Chang et al^Citation62	2015	Korea	Case–control	Ultrasound	47	47	11.5±2.6	9.60±3.20	25.6±4.3	25.1±3.8	1.0±0.28	0.94±0.11	NA	NA	0.6±0.43	0.74±0.29	6

Notes:

a Site of BMD measurement in this study was whole body.

b Sites of BMD measurement in this study were lumbar spine (L1–L4). Data are presented as mean±SD where applicable.

Abbreviations: BMC, bone mineral content; BMD, bone mineral density; BMI, body mass index; NA, not applicable; NOS, Newcastle-Ottawa Scale.

Figure 1 Flowchart of the studies’ selecting process and results.

Abbreviation: BMD, bone mineral density.

Figure 2 (A) Meta-analysis of the correlation between obese adolescents with NAFLD and obese adolescents without NAFLD in BMD (fixed effects model). (B) Meta-analysis of the correlation between obese adolescents with NAFLD and obese adolescents without NAFLD in BMD (random effects model).

Abbreviations: BMD, bone mineral density; NAFLD, nonalcoholic fatty liver disease; WMD, weighted mean difference.

Figure 3 After eliminating the low score study the graph shows the meta-analysis of the correlation between obese adolescents without NAFLD in BMD (Fixed effects model).

Abbreviations: BMD, bone mineral density; NAFLD, nonalcoholic fatty liver disease; WMD, weighted mean difference.

Figure 4 Meta-analysis of the correlation between obese adolescents with NAFLD and obese adolescents without NAFLD in Z-score (Fixed effects model).

Abbreviation: NAFLD, nonalcoholic fatty liver disease; WMD, weighted mean difference.

Figure 5 Meta-analysis of the correlation between obese adolescents with NAFLD and obese adolescents without NAFLD in BMC (Fixed effects model).

Abbreviations: BMC, bone mineral content; NAFLD, nonalcoholic fatty liver disease; WMD, weighted mean difference.

Pacifico L Bezzi M Lombardo C V Adipokines and C-reactive protein in relation to bone mineralization in pediatric nonalcoholic fatty liver disease[J World Journal of Gastroenterology 2013 19 25 4007 4014 23840146

 PubMed Web of Science ®Google Scholar

Labayen I Ruiz J R Arenaza L Hepatic fat content and bone mineral density in children with overweight/obesity [J]. Pediatr. Res 2018 84 684 688

 Web of Science ®Google Scholar

Antonella M Danilo F Elenora S Relationship between nonalcoholic steatohepatitis, PNPLA3 I148M genotype and bone mineral density in adolescents [J]. Liver International 2018 38 2301 2308

 Web of Science ®Google Scholar

Campos RMS de Piano A da Silva PL The role of pro/antiinflammatory adipokines on bone metabolism in NAFLD obese adolescents: effects of long-term interdisciplinary therapy Endocrine 2012 42 1 146 156 22315014

 PubMed Web of Science ®Google Scholar

Pirgon O Bilgin H Tolu I Correlation of insulin sensitivity with bone mineral status in obese adolescents with nonalcoholic fatty liver disease[J] Clinical Endocrinology 2011 75 2 189 195 21521307

 PubMed Web of Science ®Google Scholar

Jae C E Yong Y D Ran Y H Vitamin D Status and Bone Mineral Density in Obese Children with Nonalcoholic Fatty Liver Disease[J] Journal of Korean Medical Science 2015 30 12 1821 1827 26713058

 PubMed Web of Science ®Google Scholar