{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:06:44Z","timestamp":1793639204257,"version":"4.5.1"},"reference-count":195,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T00:00:00Z","timestamp":1714262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Research, Development and Youth of the Slovak Republic","award":["VEGA 1\/0416\/22"],"award-info":[{"award-number":["VEGA 1\/0416\/22"]}]},{"name":"Ministry of Education, Research, Development and Youth of the Slovak Republic","award":["VEGA 1\/0328\/24"],"award-info":[{"award-number":["VEGA 1\/0328\/24"]}]},{"name":"Ministry of Education, Research, Development and Youth of the Slovak Republic","award":["KEGA 034UKF-4\/2022"],"award-info":[{"award-number":["KEGA 034UKF-4\/2022"]}]},{"name":"Ministry of Education, Research, Development and Youth of the Slovak Republic","award":["KEGA 012UKF-4\/2023"],"award-info":[{"award-number":["KEGA 012UKF-4\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Obesity, type 2 diabetes mellitus (T2DM) and osteoporosis are serious diseases with an ever-increasing incidence that quite often coexist, especially in the elderly. Individuals with obesity and T2DM have impaired bone quality and an elevated risk of fragility fractures, despite higher and\/or unchanged bone mineral density (BMD). The effect of obesity on fracture risk is site-specific, with reduced risk for several fractures (e.g., hip, pelvis, and wrist) and increased risk for others (e.g., humerus, ankle, upper leg, elbow, vertebrae, and rib). Patients with T2DM have a greater risk of hip, upper leg, foot, humerus, and total fractures. A chronic pro-inflammatory state, increased risk of falls, secondary complications, and pharmacotherapy can contribute to the pathophysiology of aforementioned fractures. Bisphosphonates and denosumab significantly reduced the risk of vertebral fractures in patients with both obesity and T2DM. Teriparatide significantly lowered non-vertebral fracture risk in T2DM subjects. It is important to recognize elevated fracture risk and osteoporosis in obese and T2DM patients, as they are currently considered low risk and tend to be underdiagnosed and undertreated. The implementation of better diagnostic tools, including trabecular bone score, lumbar spine BMD\/body mass index (BMI) ratio, and microRNAs to predict bone fragility, could improve fracture prevention in this patient group.<\/jats:p>","DOI":"10.3390\/ijms25094827","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T03:30:49Z","timestamp":1714534249000},"page":"4827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Links among Obesity, Type 2 Diabetes Mellitus, and Osteoporosis: Bone as a Target"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1889-026X","authenticated-orcid":false,"given":"Monika","family":"Martiniakova","sequence":"first","affiliation":[{"name":"Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Biro","sequence":"additional","affiliation":[{"name":"Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Penzes","sequence":"additional","affiliation":[{"name":"Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1194-0692","authenticated-orcid":false,"given":"Anna","family":"Sarocka","sequence":"additional","affiliation":[{"name":"Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8491-0399","authenticated-orcid":false,"given":"Veronika","family":"Kovacova","sequence":"additional","affiliation":[{"name":"Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7186-4282","authenticated-orcid":false,"given":"Vladimira","family":"Mondockova","sequence":"additional","affiliation":[{"name":"Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6493-9880","authenticated-orcid":false,"given":"Radoslav","family":"Omelka","sequence":"additional","affiliation":[{"name":"Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s40519-018-0505-2","article-title":"The Obesity Paradox and Osteoporosis","volume":"23","author":"Fassio","year":"2018","journal-title":"Eat. Weight Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1168687","DOI":"10.3389\/fendo.2023.1168687","article-title":"The Complex Pathophysiology of Bone Fragility in Obesity and Type 2 Diabetes Mellitus: Therapeutic Targets to Promote Osteogenesis","volume":"14","author":"Bathina","year":"2023","journal-title":"Front. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s43465-023-01052-9","article-title":"Osteoporosis and Obesity","volume":"57","author":"Arjunan","year":"2023","journal-title":"Indian J. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1007\/s00223-016-0229-0","article-title":"Obesity, Type 2 Diabetes and Bone in Adults","volume":"100","author":"Walsh","year":"2017","journal-title":"Calcif. Tissue Int."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Blahova, J., Martiniakova, M., Babikova, M., Kovacova, V., Mondockova, V., and Omelka, R. (2021). Pharmaceutical Drugs and Natural Therapeutic Products for the Treatment of Type 2 Diabetes Mellitus. Pharmaceuticals, 14.","DOI":"10.3390\/ph14080806"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.2337\/dc23-S002","article-title":"2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Martiniakova, M., Babikova, M., Mondockova, V., Blahova, J., Kovacova, V., and Omelka, R. (2022). The Role of Macronutrients, Micronutrients and Flavonoid Polyphenols in the Prevention and Treatment of Osteoporosis. Nutrients, 14.","DOI":"10.3390\/nu14030523"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1186\/s13018-021-02772-0","article-title":"The Global Prevalence of Osteoporosis in the World: A Comprehensive Systematic Review and Meta-Analysis","volume":"16","author":"Salari","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"981487","DOI":"10.3389\/fendo.2022.981487","article-title":"The Pathophysiology of Osteoporosis in Obesity and Type 2 Diabetes in Aging Women and Men: The Mechanisms and Roles of Increased Bone Marrow Adiposity","volume":"13","author":"Ali","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/S0140-6736(18)32112-3","article-title":"Osteoporosis","volume":"393","author":"Compston","year":"2019","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00109-024-02418-8","article-title":"Current Knowledge of Bone-Derived Factor Osteocalcin: Its Role in the Management and Treatment of Diabetes Mellitus, Osteoporosis, Osteopetrosis and Inflammatory Joint Diseases","volume":"102","author":"Martiniakova","year":"2024","journal-title":"J. Mol. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Vescini, F., Chiodini, I., Falchetti, A., Palermo, A., Salcuni, A.S., Bonadonna, S., De Geronimo, V., Cesareo, R., Giovanelli, L., and Brigo, M. (2021). Management of Osteoporosis in Men: A Narrative Review. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222413640"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1210\/endrev\/bnab028","article-title":"Secondary Osteoporosis","volume":"43","author":"Ebeling","year":"2022","journal-title":"Endocr. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Rinonapoli, G., Ruggiero, C., Meccariello, L., Bisaccia, M., Ceccarini, P., and Caraffa, A. (2021). Osteoporosis in Men: A Review of an Underestimated Bone Condition. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22042105"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s11914-013-0135-6","article-title":"The Changing Balance between Osteoblastogenesis and Adipogenesis in Aging and Its Impact on Hematopoiesis","volume":"11","author":"Bethel","year":"2013","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1359\/jbmr.070813","article-title":"Correlation of Obesity and Osteoporosis: Effect of Fat Mass on the Determination of Osteoporosis","volume":"23","author":"Zhao","year":"2008","journal-title":"J. Bone Miner. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/ncprheum0070","article-title":"Mechanisms of Disease: Is Osteoporosis the Obesity of Bone?","volume":"2","author":"Rosen","year":"2006","journal-title":"Nat. Clin. Pract. Rheumatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"10682","DOI":"10.1038\/s41598-023-37892-6","article-title":"Association of Visceral and Subcutaneous Fat with Bone Mineral Density in US Adults: A Cross-Sectional Study","volume":"13","author":"Lin","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Pi\u00f1ar-Gutierrez, A., Garc\u00eda-Fontana, C., Garc\u00eda-Fontana, B., and Mu\u00f1oz-Torres, M. (2022). Obesity and Bone Health: A Complex Relationship. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23158303"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.2337\/db06-1656","article-title":"Visceral Fat Adipokine Secretion Is Associated with Systemic Inflammation in Obese Humans","volume":"56","author":"Fontana","year":"2007","journal-title":"Diabetes"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2337\/db08-0969","article-title":"Cortisol Release from Adipose Tissue by 11beta-Hydroxysteroid Dehydrogenase Type 1 in Humans","volume":"58","author":"Stimson","year":"2009","journal-title":"Diabetes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E385","DOI":"10.1152\/ajpendo.00052.2008","article-title":"Lower Growth Hormone and Higher Cortisol Are Associated with Greater Visceral Adiposity, Intramyocellular Lipids, and Insulin Resistance in Overweight Girls","volume":"295","author":"Misra","year":"2008","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1007\/s00125-007-0640-1","article-title":"Adipose Tissue Distribution and Risk of Metabolic Disease: Does Thiazolidinedione-Induced Adipose Tissue Redistribution Provide a Clue to the Answer?","volume":"50","author":"Yang","year":"2007","journal-title":"Diabetologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.numecd.2014.04.017","article-title":"Pro- and Anti-Inflammatory Cytokine Gene Expression in Subcutaneous and Visceral Fat in Severe Obesity","volume":"24","author":"Spoto","year":"2014","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.bone.2013.02.006","article-title":"Relationship of Adiposity to Bone Volumetric Density and Microstructure in Men and Women across the Adult Lifespan","volume":"55","author":"Ng","year":"2013","journal-title":"Bone"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"26602","DOI":"10.1074\/jbc.M601284200","article-title":"Overexpression of Monocyte Chemoattractant Protein-1 in Adipose Tissues Causes Macrophage Recruitment and Insulin Resistance*","volume":"281","author":"Kamei","year":"2006","journal-title":"J. Biol. Chem."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/j.1365-2265.2007.02853.x","article-title":"Relationship between Serum hsCRP Concentration and Biochemical Bone Turnover Markers in Healthy Pre- and Postmenopausal Women","volume":"67","author":"Kim","year":"2007","journal-title":"Clin. Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4115","DOI":"10.1210\/jc.2012-2246","article-title":"Determinants of Bone Microarchitecture and Mechanical Properties in Obese Men","volume":"97","author":"Bredella","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s00223-010-9347-2","article-title":"Negative Association between Metabolic Syndrome and Bone Mineral Density in Koreans, Especially in Men","volume":"86","author":"Kim","year":"2010","journal-title":"Calcif. Tissue Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3387","DOI":"10.1210\/jc.2008-2422","article-title":"Reciprocal Relations of Subcutaneous and Visceral Fat to Bone Structure and Strength","volume":"94","author":"Gilsanz","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/gme.0b013e31822a8d51","article-title":"Appendicular Fat Mass Is Positively Associated with Femoral Neck Bone Mineral Density in Older Women","volume":"19","author":"Marques","year":"2012","journal-title":"Menopause"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"378632","DOI":"10.1155\/2013\/378632","article-title":"Relation of Visceral and Subcutaneous Adipose Tissue to Bone Mineral Density in Chinese Women","volume":"2013","author":"Wang","year":"2013","journal-title":"Int. J. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/09513590.2020.1836147","article-title":"Lumbar Bone Mineral Density Measured by Quantitative Computed Tomography (QCT): Association with Abdominal Adipose Tissue in Different Menopausal Periods of Chinese Women","volume":"37","author":"Zhang","year":"2021","journal-title":"Gynecol. Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/jbmr.2931","article-title":"Visceral Adipose Tissue Is Associated with Bone Microarchitecture in the Framingham Osteoporosis Study","volume":"32","author":"Liu","year":"2017","journal-title":"J. Bone Miner. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1007\/s12020-014-0252-8","article-title":"Associations between Fat Distribution and Volumetric Bone Mineral Density in Chinese Adults","volume":"47","author":"Zhang","year":"2014","journal-title":"Endocrine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1002\/jbmr.3085","article-title":"Total and Visceral Adiposity Are Associated with Prevalent Vertebral Fracture in Women but Not Men at Age 62 Years: The Newcastle Thousand Families Study","volume":"32","author":"Hind","year":"2017","journal-title":"J. Bone Miner. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1474-9726.2007.00347.x","article-title":"Mitochondrial Function and Apoptotic Susceptibility in Aging Skeletal Muscle","volume":"7","author":"Chabi","year":"2008","journal-title":"Aging Cell"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1007\/s40520-020-01483-6","article-title":"Differences between Muscle from Osteoporotic and Osteoarthritic Subjects: In Vitro Study by Diffusion-Tensor MRI and Histological Findings","volume":"32","author":"Scimeca","year":"2020","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s11914-015-0274-z","article-title":"Fall and Fracture Risk in Sarcopenia and Dynapenia with and without Obesity: The Role of Lifestyle Interventions","volume":"13","author":"Scott","year":"2015","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"E368","DOI":"10.1210\/jc.2010-0780","article-title":"Fat Infiltration of Muscle, Diabetes, and Clinical Fracture Risk in Older Adults","volume":"95","author":"Schafer","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Inacio, M., Ryan, A.S., Bair, W.-N., Prettyman, M., Beamer, B.A., and Rogers, M.W. (2014). Gluteal Muscle Composition Differentiates Fallers from Non-Fallers in Community Dwelling Older Adults. BMC Geriatr., 14.","DOI":"10.1186\/1471-2318-14-37"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1359\/jbmr.090807","article-title":"Health ABC Study Computed Tomographic Measurements of Thigh Muscle Cross-Sectional Area and Attenuation Coefficient Predict Hip Fracture: The Health, Aging, and Body Composition Study","volume":"25","author":"Lang","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1152\/japplphysiol.00006.2008","article-title":"Exercise but Not Diet-Induced Weight Loss Decreases Skeletal Muscle Inflammatory Gene Expression in Frail Obese Elderly Persons","volume":"105","author":"Lambert","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1182\/blood-2014-04-572255","article-title":"Epigenetic and In Vivo Comparison of Diverse MSC Sources Reveals an Endochondral Signature for Human Hematopoietic Niche Formation","volume":"125","author":"Reinisch","year":"2015","journal-title":"Blood"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s11914-019-00550-w","article-title":"Marrow Fat-Secreted Factors as Biomarkers for Osteoporosis","volume":"17","author":"Herrmann","year":"2019","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1530\/EJE-08-0569","article-title":"Adiponectin Is Associated with Low Bone Mineral Density in Elderly Men","volume":"160","author":"Basurto","year":"2009","journal-title":"Eur. J. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1016\/j.celrep.2019.04.066","article-title":"Obesity-Associated Hypermetabolism and Accelerated Senescence of Bone Marrow Stromal Stem Cells Suggest a Potential Mechanism for Bone Fragility","volume":"27","author":"Tencerova","year":"2019","journal-title":"Cell Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1210\/jc.2008-2532","article-title":"Increased Bone Marrow Fat in Anorexia Nervosa","volume":"94","author":"Bredella","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3389\/fendo.2015.00040","article-title":"Marrow Fat and Bone: Review of Clinical Findings","volume":"6","author":"Schwartz","year":"2015","journal-title":"Front. Endocrinol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/jmri.20367","article-title":"Osteoporosis Is Associated with Increased Marrow Fat Content and Decreased Marrow Fat Unsaturation: A Proton MR Spectroscopy Study","volume":"22","author":"Yeung","year":"2005","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.acra.2015.11.009","article-title":"Bone Marrow Lipid Profiles from Peripheral Skeleton as Potential Biomarkers for Osteoporosis: A 1H-MR Spectroscopy Study","volume":"23","author":"Capuani","year":"2016","journal-title":"Acad. Radiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"116514","DOI":"10.1016\/j.bone.2022.116514","article-title":"Behavior during Aging of Bone-Marrow Fatty-Acids Profile in Women\u2019s Calcaneus to Search for Early Potential Osteoporotic Biomarkers: A 1H-MR Spectroscopy Study","volume":"164","author":"Mattioli","year":"2022","journal-title":"Bone"},{"key":"ref_53","first-page":"372","article-title":"Obesity, Osteoporosis and Bone Metabolism","volume":"20","author":"Gkastaris","year":"2020","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1530\/EJE-22-0530","article-title":"Fat, Adipokines, Bone Structure and Bone Regulatory Factors Associations in Obesity","volume":"187","author":"Vilaca","year":"2022","journal-title":"Eur. J. Endocrinol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-G\u00f3mez, J.J., P\u00e9rez-Castrill\u00f3n, J.L., Garc\u00eda de Santos, I., P\u00e9rez-Alonso, M., Izaola-Jauregui, O., Primo-Mart\u00edn, D., and De Luis-Rom\u00e1n, D.A. (2022). Influence of Obesity on Bone Turnover Markers and Fracture Risk in Postmenopausal Women. Nutrients, 14.","DOI":"10.3390\/nu14081617"},{"key":"ref_56","unstructured":"Campbell, M., and Jialal, I. (2024). StatPearls, StatPearls Publishing."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/BOR.0000000000000182","article-title":"Obesity and Fractures in Postmenopausal Women","volume":"27","author":"Compston","year":"2015","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1006\/bbrc.2001.6307","article-title":"Hormonal Regulation of Adiponectin Gene Expression in 3T3-L1 Adipocytes","volume":"290","author":"Fasshauer","year":"2002","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1007\/s00421-017-3588-y","article-title":"High Doses of Vitamin C plus E Reduce Strength Training-Induced Improvements in Areal Bone Mineral Density in Elderly Men","volume":"117","author":"Stunes","year":"2017","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Rinonapoli, G., Pace, V., Ruggiero, C., Ceccarini, P., Bisaccia, M., Meccariello, L., and Caraffa, A. (2021). Obesity and Bone: A Complex Relationship. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222413662"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.3945\/ajcn.115.120139","article-title":"Free 25-Hydroxyvitamin D Is Low in Obesity, but There Are No Adverse Associations with Bone Health","volume":"103","author":"Walsh","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s00774-017-0858-z","article-title":"Effects of Interventions with a Physical Activity Component on Bone Health in Obese Children and Adolescents: A Systematic Review and Meta-Analysis","volume":"36","author":"Chaplais","year":"2018","journal-title":"J. Bone Miner. Metab."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"em0135","DOI":"10.29333\/ejeph\/12799","article-title":"Osteocalcin: A New Phenomenon for Type 2 Diabetes and Obesity","volume":"7","author":"Kocak","year":"2023","journal-title":"Eur. J. Environ. Public Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.molmet.2014.03.004","article-title":"Osteopontin: A Novel Regulator at the Cross Roads of Inflammation, Obesity and Diabetes","volume":"3","author":"Kahles","year":"2014","journal-title":"Mol. Metab."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"935","DOI":"10.2337\/db09-0404","article-title":"Neutralization of Osteopontin Inhibits Obesity-Induced Inflammation and Insulin Resistance","volume":"59","author":"Kiefer","year":"2010","journal-title":"Diabetes"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1152\/physrev.00018.2001","article-title":"Free Radicals in the Physiological Control of Cell Function","volume":"82","year":"2002","journal-title":"Physiol. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1007\/s00774-013-0530-1","article-title":"Treatment with Hydrogen Molecules Prevents RANKL-Induced Osteoclast Differentiation Associated with Inhibition of ROS Formation and Inactivation of MAPK, AKT and NF-Kappa B Pathways in Murine RAW264.7 Cells","volume":"32","author":"Li","year":"2014","journal-title":"J. Bone Miner. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s00774-015-0656-4","article-title":"Reactive Oxygen Species and Oxidative Stress in Osteoclastogenesis, Skeletal Aging and Bone Diseases","volume":"33","author":"Callaway","year":"2015","journal-title":"J. Bone Miner. Metab."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1177\/0748233713491801","article-title":"Reactive Oxygen Species Induce Cell Death via Akt Signaling in Rat Osteoblast-like Cell Line ROS 17\/2.8","volume":"31","author":"Zhang","year":"2015","journal-title":"Toxicol. Ind. Health"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Martiniakova, M., Kovacova, V., Mondockova, V., Zemanova, N., Babikova, M., Biro, R., Ciernikova, S., and Omelka, R. (2023). Honey: A Promising Therapeutic Supplement for the Prevention and Management of Osteoporosis and Breast Cancer. Antioxidants, 12.","DOI":"10.3390\/antiox12030567"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1631\/jzus.B1800648","article-title":"IGF-1R\/\u03b2-Catenin Signaling Axis Is Involved in Type 2 Diabetic Osteoporosis","volume":"20","author":"Zhang","year":"2019","journal-title":"J. Zhejiang Univ. Sci. B"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Komori, T. (2019). Regulation of Proliferation, Differentiation and Functions of Osteoblasts by Runx2. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20071694"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"741","DOI":"10.2119\/2008-00058.Rabe","article-title":"Adipokines and Insulin Resistance","volume":"14","author":"Rabe","year":"2008","journal-title":"Mol. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s00586-013-3009-9","article-title":"Importance of Spinal Deformity Index in Risk Evaluation of VCF (Vertebral Compression Fractures) in Obese Subjects: Prospective Study","volume":"22","author":"Ruosi","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Jimi, E., and Katagiri, T. (2022). Critical Roles of NF-\u03baB Signaling Molecules in Bone Metabolism Revealed by Genetic Mutations in Osteopetrosis. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23147995"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"16390","DOI":"10.1074\/jbc.M115.674598","article-title":"CCAAT\/Enhancer-Binding Protein \u03b1 (C\/EBP\u03b1) Is Important for Osteoclast Differentiation and Activity","volume":"291","author":"Jules","year":"2016","journal-title":"J. Biol. Chem."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"409679","DOI":"10.1155\/2013\/409679","article-title":"Metabolic Risk Susceptibility in Men Is Partially Related to Adiponectin\/Leptin Ratio","volume":"2013","author":"Vega","year":"2013","journal-title":"J. Obes."},{"key":"ref_78","first-page":"450","article-title":"C\u0442a\u043d o\u043fop\u043do-pyxo\u0432o\u0433o a\u043fapa\u0442y y x\u0432op\u0438x \u043da \u0446y\u043apo\u0432\u0438\u0439 \u0434ia\u0431e\u0442","volume":"13","author":"Shchubelka","year":"2017","journal-title":"Int. J. Endocrinol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Cavati, G., Pirrotta, F., Merlotti, D., Ceccarelli, E., Calabrese, M., Gennari, L., and Mingiano, C. (2023). Role of Advanced Glycation End-Products and Oxidative Stress in Type-2-Diabetes-Induced Bone Fragility and Implications on Fracture Risk Stratification. Antioxidants, 12.","DOI":"10.3390\/antiox12040928"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.cyto.2011.09.029","article-title":"Type 2-Diabetes Is Associated with Elevated Levels of TNF-Alpha, IL-6 and Adiponectin and Low Levels of Leptin in a Population of Mexican Americans: A Cross-Sectional Study","volume":"57","author":"Mirza","year":"2012","journal-title":"Cytokine"},{"key":"ref_81","first-page":"719","article-title":"Comparison of Insulin-like Growth Factor-1 and Sclerostin Levels between Premenopausal Women with and without Diabetes Mellitus","volume":"16","author":"Sylvawani","year":"2021","journal-title":"J. Taibah Univ. Med. Sci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1210\/clinem\/dgab061","article-title":"In Men with Obesity, T2DM Is Associated with Poor Trabecular Microarchitecture and Bone Strength and Low Bone Turnover","volume":"106","author":"Vigevano","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.2147\/DMSO.S400285","article-title":"Association of Bone Turnover Markers with Type 2 Diabetes Mellitus and Microvascular Complications: A Matched Case-Control Study","volume":"16","author":"Hou","year":"2023","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Liu, B., Liu, J., Pan, J., Zhao, C., Wang, Z., and Zhang, Q. (2023). The Association of Diabetes Status and Bone Mineral Density among US Adults: Evidence from NHANES 2005-2018. BMC Endocr. Disord., 23.","DOI":"10.1186\/s12902-023-01266-w"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00592-011-0347-0","article-title":"Serum Levels of Bone Resorption Markers Are Decreased in Patients with Type 2 Diabetes","volume":"50","author":"Varsavsky","year":"2013","journal-title":"Acta Diabetol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s13098-017-0278-1","article-title":"The Impact of Type 2 Diabetes on Bone Metabolism","volume":"9","author":"Sanches","year":"2017","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s40200-016-0275-1","article-title":"Mechanisms Involved in Altered Bone Metabolism in Diabetes: A Narrative Review","volume":"15","author":"Ghodsi","year":"2016","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00441-014-1913-x","article-title":"Effects of High Glucose and High Insulin Concentrations on Osteoblast Function In Vitro","volume":"358","author":"Cunha","year":"2014","journal-title":"Cell Tissue Res."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Martiniakova, M., Blahova, J., Kovacova, V., Babikova, M., Mondockova, V., Kalafova, A., Capcarova, M., and Omelka, R. (2021). Bee Bread Can Alleviate Lipid Abnormalities and Impaired Bone Morphology in Obese Zucker Diabetic Rats. Molecules, 26.","DOI":"10.3390\/molecules26092616"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Omelka, R., Blahova, J., Kovacova, V., Babikova, M., Mondockova, V., Kalafova, A., Capcarova, M., and Martiniakova, M. (2020). Cornelian Cherry Pulp Has Beneficial Impact on Dyslipidemia and Reduced Bone Quality in Zucker Diabetic Fatty Rats. Animals, 10.","DOI":"10.3390\/ani10122435"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Liu, X., Chen, F., Liu, L., and Zhang, Q. (2023). Prevalence of Osteoporosis in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis of Observational Studies. BMC Endocr. Disord., 23.","DOI":"10.1186\/s12902-022-01260-8"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1365-2796.2012.02564.x","article-title":"New Insights into Osteoporosis: The Bone\u2013Fat Connection","volume":"272","author":"Kawai","year":"2012","journal-title":"J. Intern. Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jocd.2020.10.005","article-title":"Association of Visceral and Subcutaneous Fat Mass with Bone Density and Vertebral Fractures in Women with Severe Obesity","volume":"24","author":"Crivelli","year":"2021","journal-title":"J. Clin. Densitom."},{"key":"ref_94","unstructured":"Watson, R.R. (2019). Nutrition in the Prevention and Treatment of Abdominal Obesity, Academic Press. [2nd ed.]."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Liu, P., Ma, F., Lou, H., and Liu, Y. (2013). The Utility of Fat Mass Index vs. Body Mass Index and Percentage of Body Fat in the Screening of Metabolic Syndrome. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-629"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1001\/jama.2016.21042","article-title":"Genetic Association of Waist-to-Hip Ratio with Cardiometabolic Traits, Type 2 Diabetes, and Coronary Heart Disease","volume":"317","author":"Emdin","year":"2017","journal-title":"JAMA"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/s41574-019-0310-7","article-title":"Waist Circumference as a Vital Sign in Clinical Practice: A Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity","volume":"16","author":"Ross","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e2334836","DOI":"10.1001\/jamanetworkopen.2023.34836","article-title":"Surrogate Adiposity Markers and Mortality","volume":"6","author":"Khan","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/01.rhu.0000208612.33819.8c","article-title":"Important Determinants of Bone Strength: Beyond Bone Mineral Density","volume":"12","author":"Friedman","year":"2006","journal-title":"J. Clin. Rheumatol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s00198-003-1506-0","article-title":"EPIDOS Study Group A Comparison of Different Screening Strategies to Identify Elderly Women at High Risk of Hip Fracture: Results from the EPIDOS Prospective Study","volume":"14","author":"Piault","year":"2003","journal-title":"Osteoporos. Int."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1359\/jbmr.2003.18.11.1947","article-title":"Osteoporotic Fractures Research Group BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long-Term Results from the Study of Osteoporotic Fractures","volume":"18","author":"Stone","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1001\/archinte.164.10.1108","article-title":"Bone Mineral Density Thresholds for Pharmacological Intervention to Prevent Fractures","volume":"164","author":"Siris","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.bone.2003.10.001","article-title":"Fracture Incidence and Association with Bone Mineral Density in Elderly Men and Women: The Rotterdam Study","volume":"34","author":"Schuit","year":"2004","journal-title":"Bone"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1503\/cmaj.070234","article-title":"Low Bone Mineral Density and Fracture Burden in Postmenopausal Women","volume":"177","author":"Cranney","year":"2007","journal-title":"CMAJ"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"2787","DOI":"10.1210\/jc.2004-1568","article-title":"Study of Osteoporotic Fractures Research Group Hip Fracture in Women without Osteoporosis","volume":"90","author":"Wainwright","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_106","first-page":"1925","article-title":"Short-Term Precision Error in Dual Energy X-ray Absorptiometry, Bone Mineral Density and Trabecular Bone Score Measurements; and Effects of Obesity on Precision Error","volume":"4","author":"Hopkins","year":"2014","journal-title":"J. Biomed. Graph. Comput."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.bone.2008.11.003","article-title":"Effect of Increasing Vertebral Marrow Fat Content on BMD Measurement, T-Score Status and Fracture Risk Prediction by DXA","volume":"44","author":"Blake","year":"2009","journal-title":"Bone"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s12020-016-0857-1","article-title":"Assessment of Trabecular Bone Score (TBS) in Overweight\/Obese Men: Effect of Metabolic and Anthropometric Factors","volume":"54","author":"Romagnoli","year":"2016","journal-title":"Endocrine"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"R213","DOI":"10.1530\/EJE-18-0991","article-title":"DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of Bone Fragility in Endocrine Disorders","volume":"180","author":"Falchetti","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.amjmed.2011.06.013","article-title":"Obesity Is Not Protective against Fracture in Postmenopausal Women: GLOW","volume":"124","author":"Compston","year":"2011","journal-title":"Am. J. Med."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/jbmr.1466","article-title":"The Association between Fracture and Obesity Is Site-Dependent: A Population-Based Study in Postmenopausal Women","volume":"27","author":"Premaor","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"728","DOI":"10.3945\/an.117.015545","article-title":"Abdominal Obesity and Risk of Hip Fracture: A Systematic Review and Meta-Analysis of Prospective Studies","volume":"8","author":"Sadeghi","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1089\/jwh.2006.15.1028","article-title":"The Association between Body Mass Index and Osteoporosis in Patients Referred for a Bone Mineral Density Examination","volume":"15","author":"Asomaning","year":"2006","journal-title":"J. Womens Health"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3349\/ymj.2010.51.6.857","article-title":"Relation between Obesity and Bone Mineral Density and Vertebral Fractures in Korean Postmenopausal Women","volume":"51","author":"Kim","year":"2010","journal-title":"Yonsei Med. J."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13098-022-00840-x","article-title":"The Relationship between Central Obesity and Bone Mineral Density: A Mendelian Randomization Study","volume":"14","author":"Du","year":"2022","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jocd.2017.05.015","article-title":"Positive Association of Obesity and Insulin Resistance with Bone Mineral Density in Tunisian Postmenopausal Women","volume":"21","author":"Cherif","year":"2018","journal-title":"J. Clin. Densitom."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jocd.2019.04.006","article-title":"Does the Severity of Obesity Influence Bone Mineral Density Values in Premenopausal Women?","volume":"24","author":"Hammoud","year":"2021","journal-title":"J. Clin. Densitom."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.puhe.2019.11.001","article-title":"Association of Obesity with Bone Mineral Density and Osteoporosis in Adults: A Systematic Review and Meta-Analysis","volume":"180","author":"Qiao","year":"2020","journal-title":"Public Health"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1016\/j.clnu.2023.10.013","article-title":"The Effect of Overweight or Obesity on Osteoporosis: A Systematic Review and Meta-Analysis","volume":"42","author":"Liu","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"101403","DOI":"10.1016\/j.jocd.2023.101403","article-title":"Relationship between Obesity and Osteoporosis","volume":"26","author":"Pamganamamula","year":"2023","journal-title":"J. Clin. Densitom."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/obr.12244","article-title":"Complex Association between Body Weight and Fracture Risk in Postmenopausal Women","volume":"16","author":"Mpalaris","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"4756","DOI":"10.1210\/jc.2018-02084","article-title":"GRIO Scientific Committee Obesity, Bariatric Surgery, and Fractures","volume":"104","author":"Lespessailles","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jbmr.1486","article-title":"Obesity and Fracture in Men and Women: An Epidemiologic Perspective","volume":"27","author":"Nielson","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00774-009-0056-8","article-title":"Relationship of Body Mass Index with Main Limb Fragility Fractures in Postmenopausal Women","volume":"27","author":"Gnudi","year":"2009","journal-title":"J. Bone Miner. Metab."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Tang, X., Liu, G., Kang, J., Hou, Y., Jiang, F., Yuan, W., and Shi, J. (2013). Obesity and Risk of Hip Fracture in Adults: A Meta-Analysis of Prospective Cohort Studies. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0055077"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.bone.2013.11.024","article-title":"A United Kingdom Perspective on the Relationship between Body Mass Index (BMI) and Bone Health: A Cross Sectional Analysis of Data from the Nottingham Fracture Liaison Service","volume":"59","author":"Ong","year":"2014","journal-title":"Bone"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00198-012-2209-1","article-title":"Overweight\/Obesity and Underweight Are Both Risk Factors for Osteoporotic Fractures at Different Sites in Japanese Postmenopausal Women","volume":"24","author":"Tanaka","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"2203515","DOI":"10.1080\/07853890.2023.2203515","article-title":"Obesity and Risk of Fracture in Postmenopausal Women: A Meta-Analysis of Cohort Studies","volume":"55","author":"Liu","year":"2023","journal-title":"Ann. Med."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00198-017-4294-7","article-title":"A Meta-Analysis of the Association between Body Mass Index and Risk of Vertebral Fracture","volume":"29","author":"Kaze","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1002\/jbmr.2017","article-title":"A Meta-Analysis of the Association of Fracture Risk and Body Mass Index in Women","volume":"29","author":"Johansson","year":"2014","journal-title":"J. Bone Miner. Res."},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Turcotte, A.-F., O\u2019Connor, S., Morin, S.N., Gibbs, J.C., Willie, B.M., Jean, S., and Gagnon, C. (2021). Association between Obesity and Risk of Fracture, Bone Mineral Density and Bone Quality in Adults: A Systematic Review and Meta-Analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252487"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1002\/jbmr.1878","article-title":"The Association between Fracture Site and Obesity in Men: A Population-Based Cohort Study","volume":"28","author":"Premaor","year":"2013","journal-title":"J. Bone Miner. Res."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/sj.ijir.3901552","article-title":"Body Composition, Metabolic Syndrome and Testosterone in Ageing Men","volume":"19","author":"Allan","year":"2007","journal-title":"Int. J. Impot. Res."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1359\/jbmr.091004","article-title":"Obesity and Fractures in Postmenopausal Women","volume":"25","author":"Premaor","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_135","first-page":"307","article-title":"Pharmacological Agents and Natural Compounds: Available Treatments for Osteoporosis","volume":"71","author":"Martiniakova","year":"2020","journal-title":"J. Physiol. Pharmacol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/jbmr.536","article-title":"Effect of Denosumab Treatment on the Risk of Fractures in Subgroups of Women with Postmenopausal Osteoporosis","volume":"27","author":"McClung","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"3215","DOI":"10.1210\/jc.2008-2765","article-title":"Effect of Once-Yearly Zoledronic Acid Five Milligrams on Fracture Risk and Change in Femoral Neck Bone Mineral Density","volume":"94","author":"Eastell","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_138","first-page":"1629","article-title":"Divergent Effects of Obesity on Fragility Fractures","volume":"9","author":"Caffarelli","year":"2014","journal-title":"Clin. Interv. Aging"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"3621","DOI":"10.1210\/jc.2017-00042","article-title":"Type 2 Diabetes and Osteoporosis: A Guide to Optimal Management","volume":"102","author":"Paschou","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.metabol.2014.09.002","article-title":"Type 2 Diabetes Mellitus and Fracture Risk","volume":"63","author":"Dede","year":"2014","journal-title":"Metabolism"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"e19762","DOI":"10.1097\/MD.0000000000019762","article-title":"Prevalence of Osteoporosis in Patients with Type 2 Diabetes Mellitus in the Chinese Mainland: A Protocol of Systematic Review and Meta-Analysis","volume":"99","author":"Si","year":"2020","journal-title":"Medicine"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"e2121106","DOI":"10.1001\/jamanetworkopen.2021.21106","article-title":"Prevalence of Osteoporosis and Fracture in China: The China Osteoporosis Prevalence Study","volume":"4","author":"Wang","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1359\/jbmr.080323","article-title":"Fracture Risk in Type 2 Diabetes: Update of a Population-Based Study","volume":"23","author":"Melton","year":"2008","journal-title":"J. Bone Miner. Res."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.2337\/db16-0063","article-title":"Skeletal Metabolism, Fracture Risk, and Fracture Outcomes in Type 1 and Type 2 Diabetes","volume":"65","author":"Sellmeyer","year":"2016","journal-title":"Diabetes"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"155135","DOI":"10.1016\/j.metabol.2022.155135","article-title":"Associations of Variability in Body Weight and Glucose Levels with the Risk of Hip Fracture in People with Diabetes","volume":"129","author":"Lee","year":"2022","journal-title":"Metabolism"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1007\/s00198-005-1909-1","article-title":"Bone Mineral Density and Fracture Risk in Type-2 Diabetes Mellitus: The Rotterdam Study","volume":"16","author":"Hofman","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"3114","DOI":"10.1210\/jc.2016-1726","article-title":"Association Between Insulin Resistance and Bone Structure in Nondiabetic Postmenopausal Women","volume":"101","author":"Shanbhogue","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"e8811","DOI":"10.1097\/MD.0000000000008811","article-title":"Diabetes Mellitus Is a Risk Factor for Low Bone Mass-Related Fractures: A Meta-Analysis of Cohort Studies","volume":"96","author":"Ni","year":"2017","journal-title":"Medicine"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"607240","DOI":"10.3389\/fendo.2020.607240","article-title":"Hypogonadism, Type-2 Diabetes Mellitus, and Bone Health: A Narrative Review","volume":"11","author":"Russo","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1210\/jcem.86.1.7139","article-title":"Study of Osteoporotic Features Research Group Older Women with Diabetes Have an Increased Risk of Fracture: A Prospective Study","volume":"86","author":"Schwartz","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/aje\/kwm106","article-title":"Systematic Review of Type 1 and Type 2 Diabetes Mellitus and Risk of Fracture","volume":"166","author":"Janghorbani","year":"2007","journal-title":"Am. J. Epidemiol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s00198-006-0253-4","article-title":"Discrepancies in Bone Mineral Density and Fracture Risk in Patients with Type 1 and Type 2 Diabetes\u2014A Meta-Analysis","volume":"18","author":"Vestergaard","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1210\/jc.2012-1896","article-title":"Risk Factors for Subtrochanteric and Diaphyseal Fractures: The Study of Osteoporotic Fractures","volume":"98","author":"Napoli","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s00198-015-3279-7","article-title":"Diabetes Mellitus and Risk of Hip Fractures: A Meta-Analysis","volume":"27","author":"Fan","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"3113","DOI":"10.1007\/s00198-017-4183-0","article-title":"Risk of Low-Energy Fracture in Type 2 Diabetes Patients: A Meta-Analysis of Observational Studies","volume":"28","author":"Jia","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"455","DOI":"10.2147\/TCRM.S131945","article-title":"Fracture Risk in Patients with Type 2 Diabetes Mellitus and Possible Risk Factors: A Systematic Review and Meta-Analysis","volume":"13","author":"Moayeri","year":"2017","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/s00198-006-0137-7","article-title":"Risk Factors for Fragility Fracture in Middle Age. A Prospective Population-Based Study of 33,000 Men and Women","volume":"17","author":"Holmberg","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1002\/jbmr.3287","article-title":"Vertebral Fracture Risk in Diabetic Elderly Men: The MrOS Study","volume":"33","author":"Napoli","year":"2018","journal-title":"J. Bone Miner. Res."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s40520-016-0562-1","article-title":"Type 2 Diabetes and Risk of Low-Energy Fractures in Postmenopausal Women: Meta-Analysis of Observational Studies","volume":"29","author":"Dytfeld","year":"2017","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jdiacomp.2011.02.004","article-title":"Prevalence of Osteoporosis and Vertebral Fractures in Postmenopausal Women with Type 2 Diabetes Mellitus and Their Relationship with Duration of the Disease and Chronic Complications","volume":"25","author":"Costa","year":"2011","journal-title":"J. Diabetes Complicat."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3389\/fendo.2018.00006","article-title":"The Impact of Type 2 Diabetes on Bone Fracture Healing","volume":"9","author":"Marin","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.injury.2017.11.006","article-title":"Diabetes and Healing Outcomes in Lower Extremity Fractures: A Systematic Review","volume":"49","author":"Gortler","year":"2018","journal-title":"Injury"},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1086\/518809","article-title":"Highly Sensitive Method for Genomewide Detection of Allelic Composition in Nonpaired, Primary Tumor Specimens by Use of Affymetrix Single-Nucleotide-Polymorphism Genotyping Microarrays","volume":"81","author":"Yamamoto","year":"2007","journal-title":"Am. J. Hum. Genet."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s11914-019-00513-1","article-title":"Falls and Fractures in Diabetes-More than Bone Fragility","volume":"17","author":"Rasmussen","year":"2019","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00198-019-05190-5","article-title":"The Association between Chronic Kidney Disease, Falls, and Fractures: A Systematic Review and Meta-Analysis","volume":"31","author":"Goto","year":"2020","journal-title":"Osteoporos. Int."},{"key":"ref_166","unstructured":"Moseley, K.F. (2024, April 04). Bone Disease in Diabetes Mellitus\u2014UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/bone-disease-in-diabetes-mellitus."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1210\/jc.2012-3118","article-title":"Manitoba Bone Density Program TBS (Trabecular Bone Score) and Diabetes-Related Fracture Risk","volume":"98","author":"Leslie","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s00223-017-0330-z","article-title":"Trabecular Bone Score in Men and Women with Impaired Fasting Glucose and Diabetes","volume":"102","author":"Holloway","year":"2018","journal-title":"Calcif. Tissue Int."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"5045","DOI":"10.1210\/jc.2010-0226","article-title":"High-Resolution Peripheral Quantitative Computed Tomographic Imaging of Cortical and Trabecular Bone Microarchitecture in Patients with Type 2 Diabetes Mellitus","volume":"95","author":"Burghardt","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s00198-018-4579-5","article-title":"Type 2 Diabetes Is Associated with Higher Trabecular Bone Density but Lower Cortical Bone Density: The Vietnam Osteoporosis Study","volume":"29","author":"Chau","year":"2018","journal-title":"Osteoporos. Int."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s11914-019-00538-6","article-title":"Effects of Diabetes on Bone Material Properties","volume":"17","author":"Lekkala","year":"2019","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"R55","DOI":"10.1530\/EC-18-0456","article-title":"Update on the Impact of Type 2 Diabetes Mellitus on Bone Metabolism and Material Properties","volume":"8","author":"Picke","year":"2019","journal-title":"Endocr. Connect."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"R137","DOI":"10.1530\/EJE-16-0652","article-title":"MECHANISMS IN ENDOCRINOLOGY: Diabetes Mellitus, a State of Low Bone Turnover\u2014A Systematic Review and Meta-Analysis","volume":"176","author":"Hygum","year":"2017","journal-title":"Eur. J. Endocrinol."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"845","DOI":"10.2337\/dc07-2270","article-title":"Rosiglitazone-Associated Fractures in Type 2 Diabetes: An Analysis from A Diabetes Outcome Progression Trial (ADOPT)","volume":"31","author":"Kahn","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1210\/jc.2015-3167","article-title":"Effects of Canagliflozin on Fracture Risk in Patients With Type 2 Diabetes Mellitus","volume":"101","author":"Watts","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s12020-018-1548-x","article-title":"Efficacy of Anti-Osteoporotic Medications in Patients with Type 1 and 2 Diabetes Mellitus: A Systematic Review","volume":"60","author":"Anagnostis","year":"2018","journal-title":"Endocrine"},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2217\/fon.15.275","article-title":"Incidence Rates of Chronic Lymphocytic Leukemia in US States Are Associated with Residential Radon Levels","volume":"12","author":"Schwartz","year":"2016","journal-title":"Future Oncol."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"115268","DOI":"10.1016\/j.bone.2020.115268","article-title":"Denosumab in Postmenopausal Women with Osteoporosis and Diabetes: Subgroup Analysis of FREEDOM and FREEDOM Extension","volume":"134","author":"Ferrari","year":"2020","journal-title":"Bone"},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.bone.2016.06.017","article-title":"Teriparatide in Patients with Osteoporosis and Type 2 Diabetes","volume":"91","author":"Schwartz","year":"2016","journal-title":"Bone"},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1002\/jbmr.4697","article-title":"Diabetes Mellitus and the Benefit of Antiresorptive Therapy on Fracture Risk","volume":"37","author":"Eastell","year":"2022","journal-title":"J. Bone Miner. Res."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s11914-022-00731-0","article-title":"MicroRNA and Diabetic Bone Disease","volume":"20","author":"Daamouch","year":"2022","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1038\/nature02871","article-title":"The Functions of Animal microRNAs","volume":"431","author":"Ambros","year":"2004","journal-title":"Nature"},{"key":"ref_183","doi-asserted-by":"crossref","unstructured":"Zhang, Y.-L., Liu, L., Peymanfar, Y., Anderson, P., and Xian, C.J. (2021). Roles of MicroRNAs in Osteogenesis or Adipogenesis Differentiation of Bone Marrow Stromal Progenitor Cells. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22137210"},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"e13244","DOI":"10.1111\/acel.13244","article-title":"microRNA-146a Controls Age-Related Bone Loss","volume":"19","author":"Saferding","year":"2020","journal-title":"Aging Cell"},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"553","DOI":"10.3109\/1354750X.2014.935957","article-title":"Plasma miRNA Levels Correlate with Sensitivity to Bone Mineral Density in Postmenopausal Osteoporosis Patients","volume":"19","author":"Li","year":"2014","journal-title":"Biomarkers"},{"key":"ref_186","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1038\/ncb2211","article-title":"Obesity-Induced Overexpression of miRNA-143 Inhibits Insulin-Stimulated AKT Activation and Impairs Glucose Metabolism","volume":"13","author":"Jordan","year":"2011","journal-title":"Nat. Cell Biol."},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1128\/MCB.00894-10","article-title":"miR-130 Suppresses Adipogenesis by Inhibiting Peroxisome Proliferator-Activated Receptor Gamma Expression","volume":"31","author":"Lee","year":"2011","journal-title":"Mol. Cell Biol."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.7150\/thno.22565","article-title":"Adipocyte-Derived Exosomal MiR-27a Induces Insulin Resistance in Skeletal Muscle through Repression of PPAR\u03b3","volume":"8","author":"Yu","year":"2018","journal-title":"Theranostics"},{"key":"ref_189","doi-asserted-by":"crossref","unstructured":"Villard, A., Marchand, L., Thivolet, C., and Rome, S. (2015). Diagnostic Value of Cell-Free Circulating MicroRNAs for Obesity and Type 2 Diabetes: A Meta-Analysis. J. Mol. Biomark. Diagn., 6.","DOI":"10.4172\/2155-9929.1000251"},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"840","DOI":"10.3389\/fendo.2019.00840","article-title":"Role of MicroRNAs in the Regulation of Subcutaneous White Adipose Tissue in Individuals with Obesity and without Type 2 Diabetes","volume":"10","author":"Brovkina","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3389\/fphys.2019.00379","article-title":"Plasma Protein and MicroRNA Biomarkers of Insulin Resistance: A Network-Based Integrative-Omics Analysis","volume":"10","author":"Choi","year":"2019","journal-title":"Front. Physiol."},{"key":"ref_192","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/jcsm.12878","article-title":"MicroRNAs in Obesity, Sarcopenia, and Commonalities for Sarcopenic Obesity: A Systematic Review","volume":"13","author":"Dowling","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1002\/jbmr.2897","article-title":"Serum miRNA Signatures Are Indicative of Skeletal Fractures in Postmenopausal Women with and without Type 2 Diabetes and Influence Osteogenic and Adipogenic Differentiation of Adipose Tissue-Derived Mesenchymal Stem Cells In Vitro","volume":"31","author":"Heilmeier","year":"2016","journal-title":"J. Bone Miner. Res."},{"key":"ref_194","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1111\/jcmm.14777","article-title":"Inhibition of microRNA-222 up-Regulates TIMP3 to Promotes Osteogenic Differentiation of MSCs from Fracture Rats with Type 2 Diabetes Mellitus","volume":"24","author":"Jiang","year":"2020","journal-title":"J. Cell Mol. Med."},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.3892\/etm.2020.8867","article-title":"miR-205 Regulates Bone Turnover in Elderly Female Patients with Type 2 Diabetes Mellitus through Targeted Inhibition of Runx2","volume":"20","author":"Zhang","year":"2020","journal-title":"Exp. Ther. Med."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/9\/4827\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:35:38Z","timestamp":1760106938000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/9\/4827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,28]]},"references-count":195,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["ijms25094827"],"URL":"https:\/\/doi.org\/10.3390\/ijms25094827","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,28]]}}}