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摘要：
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摘要：无论是成人还是青少年非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）患者均存在
骨密度下降问题。随着肝脏纤维化与炎症加重，NAFLD患者骨密度下降程度可进一步加重。NAFLD合并
骨密度下降的原因一方面在于体力活动减少和维生素D缺乏等因素可同时影响NAFLD和骨密度，另一方
面，NAFLD与骨质疏松还可通过不同细胞因子如肿瘤坏死因子α（tumor necrosis factor α，TNF-α）、胎球
蛋白B、骨桥蛋白与核因子-κB受体活化因子配体（receptor activator of nuclear factor-κB ligand，RANKL）
等相互影响。NAFLD患者骨密度下降的诊断和治疗与其他骨密度下降患者基本相同，可依据双能X线
吸收检测法等进行诊断，在治疗中应注意NAFLD与骨质疏松的相互影响，进一步探索NAFLD与骨密度
相互影响的机制，并探索针对NAFLD合并骨质疏松的个体化诊疗方案。
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Abstract: Both adult and adolescent with non-alcoholic fatty liver disease (NAFLD) are related to decreased
bone mineral density. With the deterioration of fibrosis and inflammation of NAFLD, the severity of bone mineral
density decrease might aggravate accordingly. Vitamin D deficiency and limited physical activity contribute to
both NAFLD and bone mineral density decrease. Cytokines like tumor necrosis factor α (TNF-α) and fetuin B
upregulated in NAFLD also contributed to the decrease of bone mineral density. Osteoporosis related cytokines like
osteopontin and receptor activator of nuclear factor-κB ligand (RANKL) also contribute to NAFLD. Management
of bone mineral density decrease in patients with NAFLD follows guidelines of general patients with bone mineral
density decrease. Dual energy X-ray absorptiometry is suggested for evaluation of bone mineral density. Therapy
for NAFLD and osteoporosis might work interactively. Further studies should focus on pathogenesis of NAFLD
related bone mineral density change and individualized study for osteoporosis in patients with NAFLD .
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