The impact of obesity on bone health: molecular pathways, metabolic interactions, and associated pathologies

Obesity, characterized by excessive body fat accumulation, is a growing global health concern with significant implications for both metabolic and skeletal health. The increasing prevalence of obesity, particularly among children, adolescents, and postmenopausal women, is associated with various bone-related disorders. Obesity and non-alcoholic fatty liver disease (NAFLD) collectively influence bone metabolism through systemic factors such as chronic inflammation, insulin resistance, dyslipidemia, and alterations in adipose tissue function. Key mediators, including adipokines like leptin and adiponectin, along with pro-inflammatory cytokines, play crucial roles in modulating bone formation and resorption, thereby contributing to conditions such as osteopenia and osteoporosis. Moreover, the interplay between obesity, NAFLD, and bone health involves complex mechanisms, including gut microbiota dysbiosis and impaired vitamin D metabolism. Understanding these multifaceted interactions is essential for developing targeted interventions to prevent or mitigate the adverse effects of obesity and NAFLD on bone health. This review explores the molecular pathways, metabolic interactions, and associated pathologies linking obesity and NAFLD to bone health.