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REVIEW  BONE HEALTH IN WOMAN’S REPRODUCTIVE LIFE AND POSTMENOPAUSE 

Minerva Obstetrics and Gynecology 2021 December;73(6):744-53

DOI: 10.23736/S2724-606X.20.04689-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Metabolic syndrome and fragility fracture risk

Roberta COSSO 1, Alberto FALCHETTI 1, 2

1 Section of Bone and Mineral Diseases, San Giuseppe Hospital, Piancavallo, Verbania, Italy; 2 Unit for Bone Metabolism Diseases and Diabetes, Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy



INTRODUCTION: The prevalence of metabolic syndrome has been reported to extremely vary depending on the gender, age, and ethnicity studied. Approximately, 25% of the worldwide adult population is affected by metabolic syndrome, indicating it as a significantly important public health challenge. Likewise, fragility fracture represents an important public health issue too, and the lifetime residual risk of its occurrence has been established in 50% in women and 30% in men over 50 years of age, respectively. Dysmobility syndrome summarizes a cluster of co-existing conditions such as osteoporosis, sarcopenia, obesity. Currently, clinical research focuses essentially on the cardiovascular risks associated with metabolic syndrome. Today, it is conceivable to incorporate all these conditions under a generic “disorder of energy metabolism.”
EVIDENCE ACQUISITION: Animal and human studies suggest metabolic and dysmobility syndromes negatively impact on the risk for fragility fracture, contributing to increase the associated mortality rate.
EVIDENCE SYNTHESIS: In recent years, strong correlation between type 2 diabetes, a frequent constitutive part of metabolic syndrome and fragility fracture risk has been reported, but the possible molecular mechanisms by which it can occur are still to be defined.
CONCLUSIONS: Only very few human clinical studies faced these aspects, but they lack adequate endpoints for a good clinical practice in these subjects. Much more still needs to be done before appropriate therapeutic diagnostic pathways will be available for these patients at risk of bone and even generalized fragility. Suggestions for a future overall approach by generating global risk score for these conditions are given.


KEY WORDS: Fractures, bone; Metabolic syndrome; Frailty

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