MAFLD is associated with lower bone mineral density in patients with type 2 diabetes: an exploratory cross-sectional analysis of a potential indirect association with HOMA-IR - Summary - MDSpire
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MAFLD is associated with lower bone mineral density in patients with type 2 diabetes: an exploratory cross-sectional analysis of a potential indirect association with HOMA-IR
To investigate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM), emphasizing the exploratory nature of the study and exploring whether insulin resistance, as indicated by HOMA-IR, statistically accounts for part of this association.
Key Findings:
Patients in the MAFLD group had significantly lower BMD T-scores compared to the non-MAFLD group (−1.12 ± 1.16 vs. −0.50 ± 1.07, P < 0.001).
MAFLD was inversely associated with BMD after adjusting for age, sex, and BMI (β = −0.562, P = 0.003).
The indirect effect of MAFLD on BMD through HOMA-IR was statistically significant (β = −0.070, 95% CI: −0.142 to −0.015), accounting for 11.4% of the total association.
FIB-4 was not independently associated with BMD.
The prevalence of osteopenia/osteoporosis was higher in the MAFLD group (59.0% vs. 33.7%, P = 0.002).
Interpretation:
The study suggests an association between MAFLD and lower BMD in T2DM patients, with a modest indirect effect via HOMA-IR, but these findings should be interpreted as suggestive rather than conclusive.
Limitations:
Cross-sectional design limits the ability to establish causality.
Single-center study may affect generalizability.
Exclusion criteria may limit the applicability of findings to broader populations.
Conclusion:
MAFLD is associated with lower BMD in T2DM patients, with a modest indirect effect through HOMA-IR, but further research is needed to clarify causal relationships, emphasizing the exploratory nature of these findings.
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