Submitted to: Journal of Orthopaedic Surgery and Research
Publication Type: Review Article
Publication Acceptance Date: 4/1/2011
Publication Date: 6/15/2011
Citation: Cao, J.J. 2011. Effects of obesity on bone metabolism. Journal of Orthopaedic Surgery and Research. doi:10.1186/1749-799X-6-30.
Technical Abstract: Despite being a risk factor for many chronic health disorders, obesity is thought to promote bone formation and protect against osteoporosis in humans. Although body mass has a positive effect on bone health, whether mass derived from an obesity condition or excessive fat accumulation is beneficial to bone has been questioned recently. Accumulating data suggest that marrow adipogenesis is inversely related to osteoblastogenesis and that obesity is detrimental to bone health. To our knowledge, obesity can affect bone metabolism through several mechanisms. Obesity may decrease osteoblast differentiation and thus bone formation because both adipocyte and osteoblasts are derived from a common multipotential mesenchymal stem cell. Obesity is associated with elevated circulating and tissue proinflammatory cytokines that may increase osteoclast activity and bone resorption through modifying the receptor activator of NF-'B (RANK)/ RANK ligand/osteoprotegerin pathway. Furthermore, the excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may also contribute to up-regulated proinflammatory cytokine production and osteoclastogenesis. Finally, high-fat intake may interfere with intestinal calcium absorption. Unraveling the relationship between obesity and bone metabolism will help us develop strategies to aid in the prevention of both obesity and osteoporosis.