Since the beginning of the 21st century, there has been a growing interest in studying the relationship between non-alcoholic fatty liver disease (NAFLD) and bone health. Unlike other liver diseases, NAFLD is accompanied by specific metabolic changes that may reduce bone mineral density (BMD), increasing the risk of osteoporosis and fractures. The challenge lies in the limited understanding of the mechanisms connecting the liver and bone tissue, necessitating further research. Studies have shown that NAFLD is closely associated with reduced bone mineral density, particularly in Asian populations. This review discusses epidemiological data highlighting the importance of diagnosing NAFLD for the timely identification of bone disorders. Hepatokines and osteokines, such as FGF21 and osteocalcin, play a significant role in the pathogenesis of this condition. These molecules regulate metabolic exchanges between the liver and bones, confirming their key role in the development of osteopenia and osteoporosis in patients with NAFLD. However, contradictions in research findings were observed, mainly due to different methods used to diagnose NAFLD. For example, ultrasound diagnosis of hepatic steatosis often correlated with reduced BMD, whereas studies using other diagnostic methods did not always show a similar relationship.

CONCLUSION

Patients with NAFLD, especially those with additional risk factors for osteoporosis, require more thorough screening for early detection of bone density disorders and fracture prevention. The role of hepatokines and osteokines warrants further investigation, which could offer new avenues for the treatment and prevention of osteoporosis in patients with NAFLD.