The association between non-alcoholic fatty liver disease (NAFLD) and osteoarthritis (OA) has not been well elucidated. The aim of the present study was to investigate the association between NAFLD and OA in the US adults. A cross-sectional study was performed on participants in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) cycle. NAFLD was defined by the vibration-controlled transient elastography. The diagnosis of OA was based on self-reported data. Weighted multiple logistic regression models and stratified analyses were performed to explore the relationship and verify the stability of the conclusions. Sensitivity analysis using multiple imputation for missing data and propensity score matching (PSM) were performed. In total, 2622 participants [Male: 1260 (47.8%)] were included in this study with a mean age of 48.1 years old (95% CI, 46.6–49.6 years old), containing 317 (12.8%) OA patients and 1140 NAFLD patients (41.5%). A logistic regression indicated a significant association between NAFLD and OA without adjustment [odds ratio (OR) = 2.05; 95% CI, 1.52–2.78]. The association remained stable after adjustment for covariates (OR = 1.72; 95% CI, 1.26–2.34). Sensitivity analysis of missing data with multiple interpolation and PSM found similar results. A significant and consistent association of NAFLD with OA was still observed in each subgroup stratified by age and metabolic syndrome (MetS). Stratified by sex, obesity, and sensitivity c-reactive protein (hs-CRP) category, a statistically significant association was only shown in females, those without obesity, and those without hyper hs-CRP. The results illustrated that the relationship between NAFLD and OA was stable in all subgroups and had no interaction. NAFLD was positively correlated with OA. Given the current pandemic of NAFLD and OA, clinicians should screen for NAFLD in arthritis patients and intervene early.

中文翻译：

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美国成年人中非酒精性脂肪肝与自我报告的骨关节炎的关联

非酒精性脂肪肝（NAFLD）和骨关节炎（OA）之间的关联尚未得到很好的阐明。本研究的目的是调查美国成年人 NAFLD 与 OA 之间的关联。对 2017-2018 年国家健康和营养检查调查 (NHANES) 周期的参与者进行了一项横断面研究。NAFLD 是通过振动控制瞬态弹性成像来定义的。OA 的诊断基于自我报告的数据。通过加权多元Logistic回归模型和分层分析来探讨其中的关系并验证结论的稳定性。使用多重插补缺失数据和倾向评分匹配（PSM）进行敏感性分析。本研究总共纳入了 2622 名参与者[男性：1260 名（47.8%）]，平均年龄为 48.1 岁（95% CI，46.6-49.6 岁），其中 317 名（12.8%）名 OA 患者和 1140 名 NAFLD 患者患者（41.5%）。逻辑回归表明，未经调整，NAFLD 和 OA 之间存在显着相关性 [比值比 (OR) = 2.05；95% CI，1.52–2.78]。调整协变量后，该关联保持稳定（OR = 1.72；95% CI，1.26-2.34）。使用多重插值和 PSM 对缺失数据进行敏感性分析发现了类似的结果。在按年龄和代谢综合征 (MetS) 分层的每个亚组中仍观察到 NAFLD 与 OA 之间存在显着且一致的关联。按性别、肥胖和敏感性 C 反应蛋白 (hs-CRP) 类别分层，仅在女性、非肥胖者和非高 hs-CRP 者中显示出统计学上显着的关联。结果表明，NAFLD 和 OA 之间的关系在所有亚组中都很稳定，并且没有交互作用。NAFLD 与 OA 呈正相关。鉴于目前 NAFLD 和 OA 的流行，临床医生应在关节炎患者中筛查 NAFLD 并早期干预。