Bone Health in Metabolic Syndrome-Is It a Neglected Aspect of Dysmetabolic-Related Diseases?

Due to their widespread prevalence and the aging global population, metabolic syndrome (MetS) and osteoporosis represent significant public health challenges. Clinical interest in MetS is currently primarily focused on cardiovascular risks. However, emerging evidence indicates that metabolic conditions may also adversely affect bone health. Each component of MetS-especially glucose metabolism impairment, central obesity, and endocrine factors-impacts bones in distinct ways, creating a complex network of interactions that influences skeletal health. These metabolic disturbances can lead to changes in bone remodeling, potentially resulting in alterations to bone mineral density and microarchitectural structure and an increased risk of fractures. Regarding uncertain and controversial pieces of evidence about the effect of MetS on bone health, this narrative review discusses and summarizes the current research on the association of MetS and its components with bone metabolism, bone quantity (based on bone mineral density, or BMD), bone quality (based on trabecular bone score, or TBS), and fracture risk.