Abstract
So far, the connections between obesity and skeleton have been extensively explored, but the results are inconsistent. Obesity is thought to affect bone health through a variety of mechanisms, including body weight, fat volume, bone formation/resorption, proinflammatory cytokines together with bone marrow microenvironment. In this review, we will mainly describe the effects of adipokines secreted by white adipose tissue on bone cells, as well as the interaction between brown adipose tissue, bone marrow adipose tissue, and bone metabolism. Meanwhile, this review also reviews the evidence for the effects of adipose tissue and its distribution on bone mass and bone-related diseases, along with the correlation between different populations with obesity and bone health. And we describe changes in bone metabolism in patients with anorexia nervosa or type 2 diabetes. In summary, all of these findings show that the response of skeleton to obesity is complex and depends on diversified factors, such as mechanical loading, obesity type, the location of adipose tissue, gender, age, bone sites, and secreted cytokines, and that these factors may exert a primary function in bone health.
Highlights
Bone is a living tissue with metabolic functions
Obesity or overweight is strictly related to bone metabolism, the correlation has not yet been fully unified
Human obesity is a complex problem that involves excessive fat intake and other nutrient consumption imbalances such as vitamin D, calcium and phosphorus, which are known to affect bone metabolism, further making it difficult to determine the impact of obesity on human bone health
Summary
Bone is a living tissue with metabolic functions. Bone marrow mesenchymal stem cells (BMSCs) have the ability to differentiate into osteoblasts and adipocytes, which is a dynamic balance (Li et al, 2015; Li C.J. et al, 2018). Bones exhibit the characteristics of endocrine organs, which secrete a variety of hormones to participate in the endocrine cycle throughout the body. Bone can secrete estrogen, androgens, follicle suppressant and other sex hormones to participate in the reproductive process, cellular senescence, and osteoporosis (OP). Bone marrow fat cells can secrete a series of adipokine including adiponectin, leptin through autocrine, and paracrine, which play an important regulatory role in local and systemic metabolism of bone marrow. There are many metabolic osteopathy, including OP, bone tumor, and inflammatory arthritis, where this fine equilibrium is disrupted (Sun et al, 2019)
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