Fracture Risk Assessment in Metabolic Syndrome in Terms of Secondary Osteoporosis Potential. A Narrative Review

Abstract

Osteoporosis is a major global public health problem with the associated bone fractures contributing significantly to both morbidity and mortality. In many countries, osteoporotic fractures will affect one in three women and one in five men over the age of 50. Similarly, diabetes, obesity, and metabolic syndrome (MetS) are among the leading public health problems due to their worldwide prevalence and burden on health budgets. Although seemingly disparate, metabolic disorders are known to affect bone health, and the interaction between fat and bone tissue is increasingly well understood. For example, it is now well established that diabetes mellitus (both type 1 and 2) is associated with fracture risk. In this narrative review, we focus on the potential link between MetS and bone health as expressed by bone mineral density and fracture risk. This narrative review demonstrates the association of MetS and its components with increased fracture risk, and also highlights the need for fracture risk assessment in patients with obesity and MetS.

Keywords: Fracture risk assessment; Hyperglycemia; Insulin resistance; Metabolic syndrome; Obesity; Secondary osteoporosis.

Fig. 1

The graph represents the linear increase in the number of publications on the relationship between ‘abdominal obesity and bone health’ in PubMed between 2005 and 2024. Search query keywords ‘abdominal obesity and bone health’ (Data was extracted on 4th Oct 2024)

Fig. 2

Primary (framed) and secondary factors in the effects of metabolic syndrome components on bone health