{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:54:20Z","timestamp":1792086860529,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2304800"],"award-info":[{"award-number":["2022YFC2304800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2303700"],"award-info":[{"award-number":["2022YFC2303700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2022NSFSC0732"],"award-info":[{"award-number":["2022NSFSC0732"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with nonalcoholic fatty liver disease (NAFLD) are reported to have a higher risk of osteoporosis\/fractures; however, the causal relationship remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Publicly available genome\u2010wide association studies (GWASs) were used for Mendelian randomization (MR) analysis. GWASs of NAFLD and fractures were obtained from the FinnGen Consortium. GWASs of bone mineral density (BMD) were derived from a meta\u2010analysis. GWASs of obesity, diabetes, liver function, and serum lipid\u2010related metrics were used to clarify whether the accompanying NAFLD symptoms contributed to fractures. Moreover, two additional GWASs of NAFLD were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A causal association was not observed between NAFLD and BMD using GWASs from the FinnGen Consortium. However, a causal relationship between NAFLD and femoral neck\u2010BMD (FN\u2010BMD), a suggestive relationship between fibrosis and FN\u2010BMD, and between NAFLD and osteoporosis were identified in replication GWASs. Genetically proxied body mass index (BMI), high\u2010density lipoprotein (HDL), and hip circumference increased the likelihood of lower limb fractures. The waist\u2010to\u2010hip ratio decreased, whereas glycated hemoglobin (HbA1C) and homeostasis model assessment of \u03b2\u2010cell function (HOMA\u2010B) increased the risk of forearm fractures. Low\u2010density lipoprotein (LDL) reduced, whereas HbA1C increased the incidence of femoral fractures. Alkaline phosphatase (ALP) raised the risk of foot fractures. However, after a multivariate MR analysis (adjusted for BMI), all the relationships became insignificant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NAFLD caused reduced BMD, and genetically predicted HDL, LDL, HbA1C, HOMA\u2010B, ALP, hip circumference, and waist\u2010to\u2010hip ratio causally increased the risk of fractures. BMI may mediate causal relationships. Larger GWASs are required to verify this finding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.16448","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T08:30:29Z","timestamp":1705653029000},"page":"847-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Mendelian\u2010randomization study revealed causal relationship between nonalcoholic fatty liver disease and osteoporosis\/fractures"],"prefix":"10.1111","volume":"39","author":[{"given":"Xiong","family":"Pei","sequence":"first","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianchi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingmin","family":"Zeng","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Hai","family":"Liu","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9745-9832","authenticated-orcid":false,"given":"Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8523-1689","authenticated-orcid":false,"given":"Enqiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taoyou","family":"Zhou","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9790-6225","authenticated-orcid":false,"given":"Hong","family":"Tang","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-047X","authenticated-orcid":false,"given":"Dongbo","family":"Wu","sequence":"additional","affiliation":[{"name":"Center of Infectious Diseases, West China Hospital Sichuan University  Chengdu 610041 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/03602532.2017.1293683"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32511-3"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00165-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28785"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70032-4"},{"key":"e_1_2_10_8_1","first-page":"105","article-title":"The epidemiology of osteoporosis","volume":"133","author":"Clynes MA","year":"2020","journal-title":"Br. Med. Bull."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.047"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22052604"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.825448"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2013.07.006"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-016-0807-2"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac074"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.1006944"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1364-z"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-022-01078-z"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq151"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7221"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-14452-4"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/gepi.21965"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv080"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0099-7"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.34408"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04924.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v5.i11.627"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.R109.041087"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abb.2008.03.018"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41232-019-0111-3"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.05.034"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.17219\/acem\/67561"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000465455"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1990.tb03567.x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M106339200"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/235060"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2793"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-11-271"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2761w"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00030"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2008.09.020"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1112062"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1188"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1168"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365518209168118"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1210\/endo-124-2-565"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2006.09.011"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.10.010"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom13040616"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20174270"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/07435800.2019.1625057"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13730"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abb.2010.05.030"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16448","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.16448","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:01:22Z","timestamp":1791201682000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.16448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/jgh.16448"],"URL":"https:\/\/doi.org\/10.1111\/jgh.16448","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]},"assertion":[{"value":"2023-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}