SPP1 and osteoporosis: Cumulatively, the aforementioned data suggest that (1) MASLD and HTN are associated with decreased BMD, (2) bone turnover markers, OPN and P1NP, are not only involved in the regulation of bone metabolism but also play a key role in the progression of MASLD and vascular remodeling in HTN, and (3) the coexistence of osteoporosis with MASLD and HTN exacerbates long-term morbidity and negatively affects patients’ quality of life [27].