Correlation Analysis Between Liver Fibrosis And Major Osteoporosis And Hip Fracture Probability In Elderly Patients With MAFLD

Objective:This study was to investigate the correlation between significant liver fibrosis on bone mineral density and 10-year major osteoporosis and 10-year hip fracture probability in elderly patients with MAFLD.Materials and methods:A total of 200 elderly patients（100 with MAFLD and 100 without MAFLD）were included.General information,blood routine,fasting blood biochemical indexes（liver function,blood lipid,blood electrolyte,fasting blood glucose,etc.）and Lumbar and femoral neck BMD of the patients were collected.According to fibrosis 4calculator（FIB-4）,patients with MAFLD were divided into MAFLD without fibrosis group（FIB-4<1.3）and MAFLD with fibrosis group（FIB-4≥1.3）.The t test was used to analyze the difference in baseline data between patients with MAFLD and those without MAFLD.The Chi-square test analyzed differences between groups in gender,fracture history,smoking,drink alcohol 3 or more units/day,hypertension and diabetes.Spearman correlation test was used to analyze the relationship between10-year major osteoporosis and 10-year hip fracture probability and all the indicators.Unitary linear regression was used to analyze the association between FIB-4 and10-year major osteoporosis and 10-year hip fracture probability in older MAFLD patients.Logistic regression was used to analyze the association between FIB-4 index and 10-year hip fracture risk in elderly patients with MAFLD.ROC curve was used to analyze the predictive value of FIB-4 in 10-year hip fracture probability.Results:1.The results of intergroup analysis of MAFLD group showed that patients with significant fibrosis had lower BMD and higher 10-year osteoporosis fracture risk score than those without fibrosis（P=0.001）.2.Spearman correlation analysis showed that 10-year major and 10-year hip fracture probability were positively correlated with FIB-4（FRAX₁and FIB-4,r=0.340 P=0.001;FRAX₂and FIB-4,r=0.320 P=0.001）.There was a negative correlation between fracture risk and BMD of different sites.3.Unitary linear regression showed that the 10-year fracture probability was significantly positive associated with FIB-4 in elderly patients with MAFLD（FRAX₁β=0.236,95%CI:0.195～2.033,P<0.05;FRAX₂β=0.258,95%CI:0.217～1.502,P<0.05）.4.After adjusted,logistic regression showed FIB-4 index is a risk factor for10-year hip fracture risk in older MAFLD patients（OR=2.367,95%CI:1.146～4.889,P<0.05）.5.The area under ROC curve of FIB-4 was 0.718（sensitivity 75.9%,specificity60.6%,95%CI:0.614～0.822,P=0.001）for predicting the high risk of osteoporosis fractures in elderly patients with MAFLD,and the optimal cut-off value was 1.334for distinguishing between low and high risk of hip fractures.Conclusion:1.Lumbar and hip BMD decreased in elderly patients with MAFLD and liver fibrosis compared with those without fibrosis.2.In elderly patients with MAFLD,the 10-year major and 10-year hip fracture probability was positively correlated with FIB-4 score.