The relationship between bone marrow adipose tissue and bone metabolism in postmenopausal osteoporosis |
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| Affiliation: | 1. Department of Endocrinology and Metabolism, Academic Medical Center Amsterdam, The Netherlands;2. Maine Medical Center Research Institute, Scarborough, ME, USA;1. VU University Medical Center, Department of Internal Medicine, Section of Endocrinology, PO Box 7057, 1007MB, Amsterdam, The Netherlands;2. Academic Medical Center/University of Amsterdam, Department of Radiology and Nuclear Medicine, PO Box 22660, 1100DD, Amsterdam, The Netherlands;3. Academic Medical Center/University of Amsterdam, Department of Endocrinology and Metabolism, The Netherlands;4. Maine Medical Center Research Institute, Center for Clinical and Translational Medicine, 81 Research Drive, 04074 Scarborough, ME, USA;5. Leiden University Medical Center, Department of Internal Medicine, Albinusdreef 2, PO Box 9600, 2300RC Leiden, The Netherlands;6. Academic Medical Center/University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, The Netherlands;7. University of Washington, Bone and Joint Center, Box 354740, 4245 Roosevelt Way N.E., Seattle, WA 98105-6920, USA;8. University of Liverpool, Institute of Ageing and Chronic Disease, 6 West Derby Street, Liverpool L7 8TX, United Kingdom;9. VU University Medical Center, Department of Clinical Chemistry, The Netherlands;1. Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;2. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;1. Division of Endocrinology and Diabetes, The Children''s Hospital of Philadelphia, Philadelphia, USA;2. Division of Oncology, The Children''s Hospital of Philadelphia, Philadelphia, USA;3. Perelman School of Medicine, Department of Pediatrics, University of Pennsylvania, Philadelphia, USA |
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| Abstract: | Postmenopausal osteoporosis (PMOP) is a prevalent skeletal disorder associated with menopause-related estrogen withdrawal. PMOP is characterized by low bone mass, deterioration of the skeletal microarchitecture, and subsequent increased susceptibility to fragility fractures, thus contributing to disability and mortality. Accumulating evidence indicates that abnormal expansion of marrow adipose tissue (MAT) plays a crucial role in the onset and progression of PMOP, in part because both bone marrow adipocytes and osteoblasts share a common ancestor lineage. The cohabitation of MAT adipocytes, mesenchymal stromal cells, hematopoietic cells, osteoblasts and osteoclasts in the bone marrow creates a microenvironment that permits adipocytes to act directly on other cell types in the marrow. Furthermore, MAT, which is recognized as an endocrine organ, regulates bone remodeling through the secretion of adipokines and cytokines. Although an enhanced MAT volume is linked to low bone mass and fractures in PMOP, the detailed interactions between MAT and bone metabolism remain largely unknown. In this review, we examine the possible mechanisms of MAT expansion under estrogen withdrawal and further summarize emerging findings regarding the pathological roles of MAT in bone remodeling. We also discuss the current therapies targeting MAT in osteoporosis. A comprehensive understanding of the relationship between MAT expansion and bone metabolism in estrogen deficiency conditions will provide new insights into potential therapeutic targets for PMOP. |
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| Keywords: | Postmenopausal osteoporosis Estrogen withdrawal Marrow adipose tissue Bone metabolism |
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