<p>Relationship Between Metabolic Syndrome and Bone Health – An Evaluation of Epidemiological Studies and Mechanisms Involved</p>

Abstract

Metabolic syndrome (MetS) and osteoporosis are two medical problems plaguing the ageing populations worldwide. Though seemingly distinctive to each other, metabolic derangements are shown to influence bone health. This review summarises the relationship between MetS and bone health derived from epidemiological studies and explains the mechanistic basis of this relationship. The discourse focuses on the link between MetS and bone mineral density, quantitative sonometric indices, geometry and fracture risk in humans. The interesting sex-specific trend in the relationship, probably due to factors related to body composition and hormonal status, is discussed. Mechanistically, each component of MetS affects the bone distinctly, forming a complex interacting network influencing the skeleton. Lastly, the effects of MetS management, such as pharmacotherapies, exercise and bariatric surgery, on bone, are presented. This review aims to highlight the significant relationship between MetS and bone, and proper management of MetS with the skeletal system in mind could prevent cardiovascular and bone complications.

Direct and Indirect Effect of Honey as a Functional Food Against Metabolic Syndrome and Its Skeletal Complications

“… 27–29 The association of MetS with low BMD and osteoporosis had been demonstrated in systematic review and meta-analysis. 28–30 …”

“… 32 , 33 Besides, reactive oxygen species (ROS) is generated during MetS due to excessive macronutrients intake and inflammation. 28 , 34 , 35 ROS like hydrogen peroxide also reciprocally promotes the oxidative activation and self-amplification of the inflammatory response. 34 , 35 Eventually, the oxidative stress and inflammation events promote the osteoclastogenesis and inhibit the osteoblastogenesis, thereby affecting bone homeostasis and causing bone loss.…”

“… 34 , 35 Eventually, the oxidative stress and inflammation events promote the osteoclastogenesis and inhibit the osteoblastogenesis, thereby affecting bone homeostasis and causing bone loss. 28 …”

“…Constituents of MetS such as dyslipidemia, abdominal obesity, hyperglycemia and hypertension are co-expressed in individuals with osteopenia or osteoporosis. [27][28][29] The association of MetS with low BMD and osteoporosis had been demonstrated in systematic review and meta-analysis. [28][29][30] Chronic low-grade inflammation and oxidative stress present in MetS play major roles in inducing osteoporosis or bone loss.…”

Potential mechanisms linking psychological stress to bone health

“…Multiple studies show that body weight is directly proportional to BMD 130 , possibly via increasing mechanical loading of the body and synthesis of oestrogen by the adipose cells, which subsequently stimulate osteoblast activity 7 . At the same time, adipose tissue is a source of PICs, which are detrimental to bone health 131 . However, the association between chronic stress and body mass index remains unclear and confounded by age, gender, and race 132 .…”