Physiological and Endocrine Crosstalk between Adipose Tissue Hormones and Bone Metabolism: Implications for Osteoporosis

Abstract

Aims: The objective of this review is to summarize the physiological and endocrine interplay of adipose tissue hormones, such as resistin, chemerin, and adiponectin, with bones. It also intends to answer how disturbances in these hormones are involved in the development or progression of osteoporosis. Study Design: Narrative review based on current scientific evidence examining the mechanisms linking adipose tissue function, adipokine secretion, bone remodeling, and osteoporosis risk. Place and Duration of Study: This review was conducted at the Health and Medical Techniques College, Northern Technical University, Iraq, between January and October 2025. Methodology: A focused review of recent peer-reviewed studies was conducted to examine the hormonal functions of adipose tissue and their effects on bone-forming osteoblasts and bone-resorbing osteoclasts. The literature highlights key molecular pathways, hormone expression patterns, and their impact on bone mineral density. Overall, the findings indicate that adipose-derived hormones and skeletal tissue share interconnected endocrine pathways that influence bone metabolism. Results: Evidence indicates that altered adipokine profiles significantly influence bone remodeling. Resistin expression increases during osteoclast differentiation and is associated with reduced bone density. Chemerin demonstrates a negative regulatory effect on osteogenesis and is elevated in individuals with obesity, contributing to impaired bone quality. Adiponectin exhibits dual actions: it enhances osteoblast proliferation while also promoting pathways linked to osteoclast activation. Overall, elevated levels of these adipokines are consistently associated with decreased bone mineral density and greater susceptibility to osteoporotic fractures. The findings highlight a strong metabolic and inflammatory link between adipose tissue dysfunction and osteoporosis. Conclusion: Adipose tissue hormones play a critical role in bone metabolism and may serve as biomarkers and therapeutic targets for osteoporosis. Understanding this adipose–bone endocrine axis may support early risk identification and guide future strategies aimed at preventing or managing osteoporosis. decrease medical as well as financial burden, hence improving the management of cirrhotic patients. These predictors, however, need further work to validate reliability.