{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:27:02Z","timestamp":1783013222893,"version":"3.54.6"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease, a condition of fatty infiltration in the liver, is mostly observed in women. Women after menopause are more likely to develop insulin resistance, hyperlipidemia, and visceral fat storage, which are all recognized to be risk factors for MASLD. Chronic low\u2010grade inflammation in hepatocytes, which is a hallmark of MASLD, may significantly affect bone metabolism. This study aimed to evaluate the relationship between MASLD and bone markers in postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study is a cross\u2010sectional study, carried out in Manmohan Memorial Teaching Hospital, Kathmandu from March 2019 to August 2019. Altogether 105 cases of MASLD and non\u2010MASLD postmenopausal women were included in this study as case and control respectively. Anthropometric measurements were recorded using a standard checklist. Serum calcium, phosphorus, and alkaline phosphatase were measured, and statistical analysis was done using SPSS version 16. A\n                      <jats:italic>p<\/jats:italic>\n                      value\u2009&lt;\u20090.05 was indicated as statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age of postmenopausal women did not differ significantly between those with and without MASLD (Non\u2010MASLD: 60.0 years, IQR 53.0\u201369.0; MASLD: 58.0 years, IQR 55.0\u201365.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.66). Similarly, systolic and diastolic blood pressures (SBP and DBP) showed no significant differences between the groups. Women with MASLD, however, exhibited higher anthropometric measurements, including body mass index (BMI: 26.4 vs. 20.3\u2009kg\/m\u00b2) and waist circumference (WC: 96.5\u2009cm vs. 88.9\u2009cm). Biochemically, median serum calcium levels were significantly lower in women with MASLD (8.9\u2009mg\/dL, IQR 8.1\u20139.7), while median serum phosphorus (4.9\u2009mg\/dL, IQR 4.3\u20136.3) and alkaline phosphatase (ALP) levels (197.8\u2009U\/L, IQR 166.7\u2013247.5) were significantly higher compared to the non\u2010MASLD group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study showed significant changes in bone markers (serum calcium, phosphorus, and ALP) in postmenopausal women with MASLD than those without MASLD. Throughout our study, confounding factors such as BMI and waist circumference have significantly influenced the occurrence of bone disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71777","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:05:49Z","timestamp":1771509949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Metabolic Dysfunction Associated Steatotic Liver Disease and Bone Turnover Markers in Postmenopausal Women: A Cross\u2010Sectional Study in Central Nepal"],"prefix":"10.1002","volume":"9","author":[{"given":"Sunita","family":"Maharjan","sequence":"first","affiliation":[{"name":"Manmohan Memorial Institute of Health Sciences Kathmandu Nepal"},{"name":"Grande International Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1778-4345","authenticated-orcid":false,"given":"Pragyan","family":"Dahal","sequence":"additional","affiliation":[{"name":"Grande International Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishal","family":"Ranabhat","sequence":"additional","affiliation":[{"name":"Grande International Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna","family":"Shakya","sequence":"additional","affiliation":[{"name":"Manmohan Memorial Institute of Health Sciences Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50193"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.12669"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000520"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i19.3407"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0843-6"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.199760"},{"issue":"1","key":"e_1_2_14_10_1","first-page":"58","article-title":"Correlation of Common Biochemical Markers for Bone Turnover, Serum Calcium, and Alkaline Phosphatase in Post\u2010Menopausal Women","volume":"21","author":"Bhattarai T.","year":"2014","journal-title":"Malaysian Journal of Medical Sciences: MJMS"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddu041"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.5958\/2320-608X.2019.00001.5"},{"key":"e_1_2_14_13_1","unstructured":"C.Roeca Z.Al\u2010Safi andN.Santoro \u201cThe Postmenopausal Women \u201d Endotext 2000."},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116138"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S145191"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665108007003"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.25"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-2325"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199502023320506"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1621100"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000212608.59090.08"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.02.033"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12291-009-0049-3"},{"key":"e_1_2_14_24_1","first-page":"791","volume-title":"Textbook of Biochemistry for Medical Students","author":"Vasudevan D. 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