Association between Serum Osteocalcin Level and Non-alcoholic Fatty Liver Disease in Adults: a Meta-analysis

Abstract

Background The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing by years and has become a major public health problem. Serum osteocalcin (OCN), as a marker of bone formation, may increase the risk of NAFLD. Objective To conduct a Meta-analysis to quantitatively evaluate the association between imaging or biopsy-confirmed NAFLD and serum OCN levels. Methods English databases including Medline, Embase, Web of Science, Cochrane, and PROSPERO, as well as Chinese databases including CNKI, Wanfang Data, and VIP were searched for case-control studies, cross-sectional studies, and cohort studies on serum OCN and NAFLD. Two investigators screened the literature, extracted data and performed quality evaluation. Meta-analysis was performed using Stata 16.0 software. Results A total of 13 papers involving 11 772 participants were included. Meta-analysis showed that serum OCN levels were lower in patients with NAFLD than in those without NAFLD (SMD=-0.73, 95%CI=-1.20 to -0.27, P<0.05) ; The incidence of NFALD in the lowest quartile of serum OCN was higher than that in the highest quartile of OCN (OR=2.19, 95%CI=1.15 to 4.17, P<0.05). The results of subgroup analysis showed that the presence of comorbid underlying diseases, study quality, and study design were not sources of heterogeneity. The results of the sensitivity analysis showed that the results of Meta-analysis were not significantly affected by the deletion of 1 study, indicating stable and reliable results. Statistical publication bias was not revealed by Egger's test (P=0.519) . Conclusion Our results suggest that serum OCN levels are negatively associated with an increased risk of NAFLD.

Keywords

• non-alcoholic fatty liver disease|osteocalcin|observational study|meta-analysis