{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:04:31Z","timestamp":1790935471324,"version":"4.1.0"},"reference-count":190,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III","award":["PI18-00803"],"award-info":[{"award-number":["PI18-00803"]}]},{"name":"Instituto de Salud Carlos III","award":["PI21-01069"],"award-info":[{"award-number":["PI21-01069"]}]},{"name":"Instituto de Salud Carlos III","award":["PI18-01235"],"award-info":[{"award-number":["PI18-01235"]}]},{"name":"Instituto de Salud Carlos III","award":["PI-0268-2019"],"award-info":[{"award-number":["PI-0268-2019"]}]},{"name":"Instituto de Salud Carlos III","award":["CD20\/00022"],"award-info":[{"award-number":["CD20\/00022"]}]},{"name":"European Regional Development Fund (FEDER)","award":["PI18-00803"],"award-info":[{"award-number":["PI18-00803"]}]},{"name":"European Regional Development Fund (FEDER)","award":["PI21-01069"],"award-info":[{"award-number":["PI21-01069"]}]},{"name":"European Regional Development Fund (FEDER)","award":["PI18-01235"],"award-info":[{"award-number":["PI18-01235"]}]},{"name":"European Regional Development Fund (FEDER)","award":["PI-0268-2019"],"award-info":[{"award-number":["PI-0268-2019"]}]},{"name":"European Regional Development Fund (FEDER)","award":["CD20\/00022"],"award-info":[{"award-number":["CD20\/00022"]}]},{"name":"Instituto de Salud Carlos III","award":["PI18-00803"],"award-info":[{"award-number":["PI18-00803"]}]},{"name":"Instituto de Salud Carlos III","award":["PI21-01069"],"award-info":[{"award-number":["PI21-01069"]}]},{"name":"Instituto de Salud Carlos III","award":["PI18-01235"],"award-info":[{"award-number":["PI18-01235"]}]},{"name":"Instituto de Salud Carlos III","award":["PI-0268-2019"],"award-info":[{"award-number":["PI-0268-2019"]}]},{"name":"Instituto de Salud Carlos III","award":["CD20\/00022"],"award-info":[{"award-number":["CD20\/00022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Recent scientific evidence has shown an increased risk of fractures in patients with obesity, especially in those with a higher visceral adipose tissue content. This contradicts the old paradigm that obese patients were more protected than those with normal weight. Specifically, in older subjects in whom there is a redistribution of fat from subcutaneous adipose tissue to visceral adipose tissue and an infiltration of other tissues such as muscle with the consequent sarcopenia, obesity can accentuate the changes characteristic of this age group that predisposes to a greater risk of falls and fractures. Other factors that determine a greater risk in older subjects with obesity are chronic proinflammatory status, altered adipokine secretion, vitamin D deficiency, insulin resistance and reduced mobility. On the other hand, diagnostic tests may be influenced by obesity and its comorbidities as well as by body composition, and risk scales may underestimate the risk of fractures in these patients. Weight loss with physical activity programs and cessation of high-fat diets may reduce the risk. Finally, more research is needed on the efficacy of anti-osteoporotic treatments in obese patients.<\/jats:p>","DOI":"10.3390\/ijms23158303","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T21:11:05Z","timestamp":1658956265000},"page":"8303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["Obesity and Bone Health: A Complex Relationship"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7834-1145","authenticated-orcid":false,"given":"Ana","family":"Pi\u00f1ar-Gutierrez","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Division, University Hospital Virgen del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-6022","authenticated-orcid":false,"given":"Cristina","family":"Garc\u00eda-Fontana","sequence":"additional","affiliation":[{"name":"Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-5561","authenticated-orcid":false,"given":"Beatriz","family":"Garc\u00eda-Fontana","sequence":"additional","affiliation":[{"name":"Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9645-3260","authenticated-orcid":false,"given":"Manuel","family":"Mu\u00f1oz-Torres","sequence":"additional","affiliation":[{"name":"Bone Metabolic Unit, Endocrinology and Nutrition Division, University Hospital Cl\u00ednico San Cecilio, 18016 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada (Ibs. GRANADA), 18012 Granada, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Medicine, University of Granada, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1177\/2042018815611004","article-title":"The obesity of bone","volume":"6","author":"Greco","year":"2015","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"National Institutes of Health (2001). Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy Osteoporosis prevention, diagnosis, and therapy. 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