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The bone-heart axis: A crucial dialogue in cardiovascular disease

Ying Liu1, Qi Yao1, Jiabin Yu1

  • 1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, PR China.

Metabolism: Clinical and Experimental
|June 21, 2025
PubMed

Insights

The skeletal system influences cardiovascular diseases (CVDs) through the "bone-heart axis". Understanding this crosstalk is key for developing new treatments for conditions like atherosclerosis and heart failure.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Skeletal Biology

Background:

  • Cardiovascular diseases (CVDs) are a leading cause of death globally.
  • The skeletal system plays an endocrine role, influencing cardiovascular health.
  • Emerging research highlights the
  • bone-heart axis
  • a bidirectional communication network between bone and heart.

Purpose of the Study:

  • To explore the role of osteocrine factors in cardiovascular regulation.
  • To elucidate the mechanisms of the bone-heart axis in CVD pathogenesis.
  • To advocate for a shift towards understanding interorgan communication for therapeutic development.

Main Methods:

  • Review of current scientific literature on osteocrine factors and CVDs.
  • Analysis of the regulatory networks between skeletal and cardiovascular systems.
  • Investigation of pathological processes influenced by the bone-heart axis.

Main Results:

  • Osteocrine factors (FGF23, LCN2, DKK1, MYDGF, OCN, SOST) are implicated in cardiovascular regulation.
  • The bone-heart axis influences mineral metabolism, vascular calcification, and myocardial energy.
  • Dysregulation of this axis accelerates atherosclerosis (AS) and heart failure (HF).

Conclusions:

  • The bone-heart axis is a critical determinant of cardiovascular health.
  • Understanding the spatiotemporal dynamics of this axis is essential for precision medicine.
  • Targeting the bone-heart crosstalk offers potential for integrated skeletal and cardiovascular protection.

Keywords:
Bone-heart axisCardiovascular diseaseFGF23Metabolic-inflammatory networksSOST

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