On the Relationship Between Non-alcoholic Fatty Liver Disease with Body Composition and Bone Mineral Density in Overweight/Obese Adolescents

Background: Nonalcoholic fatty liver disease (NAFLD) is a health problem growing in line with the rising prevalence of obesity in children and adolescents, which may be correlated with different metabolic abnormalities such as osteoporosis. Objectives: This study aimed to evaluate the possible relationship between NAFLD with body composition and bone mineral density (BMD) in obese and overweight adolescents. Methods: This cross-sectional study encompassed 70 adolescents aged 11 - 18 years and was conducted during March 2016 and September 2016 in Mashhad, Iran. Anthropometric parameters and blood biomarkers were measured. Fat mass, fat-free mass, and BMD were determined using dual-energy X-ray absorptiometry (DXA) scans, and NAFLD was also assessed using Fibroscan. All statistical data were analyzed using SPSS software version 21. Multivariate linear regression assessed the relationship between liver fat content with bone-related indicators, and multivariate logistic regression detected the relationship between body composition and NAFLD. Results: Total and trunk fat mass were significantly correlated with higher NAFLD even after controlling for intervening factors (total fat mass, OR = 1.27; 95% CI, 1.016 to 1.59, P = 0.036; trunk fat mass, OR = 1.35; 95% CI, 0.97 to 1.88, P = 0.045). Moreover, liver fat content was significantly correlated with lower BMD Z-score after adjusting for gender, BMI Z-score, ALT, fat mass index, total lean mass, and physical activity (beta = -0.285, P = 0.048). Conclusions: The findings of the present study suggest that excess adipose tissue is correlated with higher NAFLD. Moreover, liver steatosis may be correlated with decreased BMD Z-score in overweight/obese adolescents.