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Osteoporosis and Obesity

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Introduction

This article concisely overviews the complex relationship between obesity and bone health. Obesity, characterized by excessive fat accumulation, has been traditionally associated with higher bone mineral density. Also, recent data suggest a favorable bone microarchitecture profile in these patients. However, the increase in bone mineral density does not necessarily confer protection against fractures, and the risk of fractures may vary depending on the skeletal sites.

Factors affecting bone health

Various factors, including mechanical factors, hormones, cytokines, inflammation, and bone marrow adiposity, contribute to the adverse effect of obesity on bone. The article explores these factors alongside non-invasive techniques and tools like the Fracture Risk Assessment (FRAX) to evaluate fracture risk.

Bone and Adipose tissue

This article also highlights the essential roles of hormones such as vitamin D, Parathormone (PTH), FGF-23 (Fibroblast Growth Factor 23), which affect bone health, and some of the hormones secreted from the adipose tissues such as adiponectin and leptin.

Obesity Paradox and Sarcopenic Obesity

The article delves into the intriguing obesity paradox, where an increased BMI correlates with higher bone mineral density but not necessarily reduced fracture risk. Sarcopenic obesity, a combination of excessive fat accumulation and reduced muscle mass, further complicates the relationship between obesity and bone health.

Conclusions

Physicians should keep a comprehensive approach to treating obese patients with osteoporosis, including lifestyle modifications, weight management, fall prevention strategies, and pharmacological interventions. Further research is needed to better understand the relationship between obesity and bone health.

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Authors and Affiliations

  1. Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Nehru Hospital Extension, Chandigarh, India

    Durairaj Arjunan, Trupti Nagendra Prasad & Sanjay Kumar Bhadada

  2. Department of Telemedicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Liza Das

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  1. Durairaj Arjunan
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Correspondence to Sanjay Kumar Bhadada.

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Arjunan, D., Prasad, T.N., Das, L. et al. Osteoporosis and Obesity. JOIO 57 (Suppl 1), 218–224 (2023). https://doi.org/10.1007/s43465-023-01052-9

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