The Regulation of Bone Metabolism by the Liver

Abstract

Chronic liver diseases and osteoporosis, seemingly unrelated diseases that occur with advanced age, are involved in different mechanisms contributing to liver and bone metabolic disorders. Secondary osteoporosis and increased bone fragility are common complications in patients with chronic liver disease, including common liver diseases such as nonalcoholic fatty liver disease, alcoholic fatty liver disease, and cholestatic hepatitis. Despite these associations, the intricate link between the liver and bones remains ambiguous. Here, we review the current molecules involved in liver-bone communication in three aspects: metabolic factors in the liver, hepatic modifying enzymes, and pro-inflammatory factors affected by liver and bone metabolism. The emphasis is on delineating the regulation of bone metabolism by the liver, with the aim of elucidating the intricate interplay between hepatic and bone metabolic processes. This exploration not only contributes to a better understanding of the dynamic relationship between the liver and bone but also lays the groundwork for more comprehensive therapeutic strategies targeting osteoporosis in patients with advanced chronic liver disease.