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Review
. 2022 Jul 27;23(15):8303.
doi: 10.3390/ijms23158303.

Obesity and Bone Health: A Complex Relationship

Ana Piñar-Gutierrez  1 , Cristina García-Fontana  2   3   4 , Beatriz García-Fontana  2   3   4 , Manuel Muñoz-Torres  2   3   4   5
Affiliations
Review

Obesity and Bone Health: A Complex Relationship

Ana Piñar-Gutierrez et al. Int J Mol Sci. .

Abstract

Recent scientific evidence has shown an increased risk of fractures in patients with obesity, especially in those with a higher visceral adipose tissue content. This contradicts the old paradigm that obese patients were more protected than those with normal weight. Specifically, in older subjects in whom there is a redistribution of fat from subcutaneous adipose tissue to visceral adipose tissue and an infiltration of other tissues such as muscle with the consequent sarcopenia, obesity can accentuate the changes characteristic of this age group that predisposes to a greater risk of falls and fractures. Other factors that determine a greater risk in older subjects with obesity are chronic proinflammatory status, altered adipokine secretion, vitamin D deficiency, insulin resistance and reduced mobility. On the other hand, diagnostic tests may be influenced by obesity and its comorbidities as well as by body composition, and risk scales may underestimate the risk of fractures in these patients. Weight loss with physical activity programs and cessation of high-fat diets may reduce the risk. Finally, more research is needed on the efficacy of anti-osteoporotic treatments in obese patients.

Keywords: body composition; fracture; healthy aging; inflammation; obesity; osteoporosis.

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Conflict of interest statement

The authors declare no conflict of interest. The funders played no role in the writing of the manuscript or in the decision to publish the results.

Figures

Figure 1
Figure 1
Pathophysiological mechanisms that relate obesity to bone health. Arrows indicate increase or decrease levels.
Figure 2
Figure 2
Current measures for the prevention of bone health issues related to obesity.
See this image and copyright information in PMC

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