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The Hormonal Milieu in Obesity and Influences on the Trabecular, Cortical, and Geometric Properties of Bone
Book chapter

The Hormonal Milieu in Obesity and Influences on the Trabecular, Cortical, and Geometric Properties of Bone

Sue A. Shapses and Deeptha Sukumar
Nutritional Influences on Bone Health, pp 43-60
17 Feb 2013
DOI: https://doi.org/10.1007/978-1-4471-2769-7_4

Abstract

Body composition Cortical Hormones Obesity Trabecular Volumetric bone mineral density
Obesity is associated with alterations in several endocrine factors, some of which are involved in regulating bone metabolism. The higher serum concentrations of parathyroid hormone (PTH), estradiol, pancreatic hormones, and adipokines such as leptin, resistin, and cytokines and the lower 25-hydroxyvitamin D (25OHD) have specific actions on the skeleton and regulate cortical and trabecular bone differently. Recent evidence suggests that bone quality is altered in obesity with a higher trabecular volumetric bone mineral density (vBMD), while cortical vBMD is lower. Also, the obese are at greater risk of fracture for a given BMD compared to normal weight individuals supporting the evidence that bone quality is altered due to excess adiposity. Higher concentrations of serum PTH have a catabolic effect on cortical bone and may play a role in reducing cortical vBMD in obesity. The lower serum 25OHD, higher leptin and resistin, and lower adiponectin may also independently contribute to the lower cortical vBMD in obesity. There is little evidence to show that higher pancreatic hormones and cytokines influence trabecular and cortical bone in obesity. The altered hormonal milieu in obesity is one important factor that explains bone architectural changes that occur due to excess adiposity. However, other factors such as diet, genetic factors, altered mechanical loading, and/or other environmental factors may also contribute to bone quality and site-specific fracture risk in obesity.

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