Energy metabolism and the skeleton:Reciprocal interplay

来源 :World Journal of Orthopedics | 被引量 : 0次 | 上传用户:lw8312188
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The relation between bone remodelling and energy expenditure is an intriguing,and yet unexplained,challenge of the past ten years. In fact,it was only in the last few years that the skeleton was found to function,not only in its obvious roles of body support and protection,but also as an important part of the endocrine system. In particular,bone produces different hormones,like osteocalcin(OC),which influences energy expenditure in humans. The undercarboxylated form of OC has a reduced affinity for hydroxyapatite; hence it enters the systemic circulation more easily and exerts its metabolic functions for the proliferation of pancreatic β-cells,insulin secretion,sensitivity,and glucose tolerance. Leptin,a hormone synthesized by adipocytes,also has an effect on both bone remodelling and energy expenditure; in fact it inhibits appetite through hypothalamic influence and,in bone,stimulates osteoblastic differentiation and inhibits apoptosis. Leptin and serotonin exert opposite influences on bone mass accrual,but several features suggest that they might operate in the same pathway through a sympathetic tone. Serotonin,in fact,acts via two opposite pathways in controlling bone remodelling: central and peripheral. Serotonin product by the gastrointestinal tract(95%) augments bone formation by osteoblast,whereas brain-derived serotonin influences low bone mineral density and its decrease leads to an increase in boneresorption parameters. Finally,amylin(AMY) acts as a hormone that alters physiological responses related to feeding,and plays a role as a growth factor in bone. In vitro AMY stimulates the proliferation of osteoblasts,and osteoclast differentiation. Here we summarize the evidence that links energy expenditure and bone remodelling,with particular regard to humans. The relation between bone remodeling and energy expenditure is an intriguing, and yet unexplained, challenge of the past ten years. In fact, it was only in the last few years that the skeleton was found to function, not only in its obvious roles of body support and protection, but also as an important part of the endocrine system. In particular, the production of hormones, like osteocalcin (OC), which influences energy expenditure in humans. The undercarboxylated form of OC has a reduced affinity for hydroxyapatite; hence enters the systemic circulation more easily and exerts its metabolic functions for the proliferation of pancreatic β-cells, insulin secretion, sensitivity, and glucose tolerance. inpts, a hormone synthesized by adipocytes, also has an effect on both bone remodeling and energy expenditure; in fact it inhibits appetite through hypothalamic influence and, in bone, stimulates osteoblastic differentiation and inhibits apoptosis. Leptin and serotonin exert then influences on bone mass accrual, but several features suggest that they might operate in the same pathway through a sympathetic tone. Serotonin, in fact, acts via two opposite pathways in controlling bone remodeling: central and peripheral. Serotonin product by the gastrointestinal tract (95% ) augments bone formation by osteoblast, whereas brain-derived serotonin influences low bone mineral density and its decrease leads to an increase in bone factor selection parameters. Finally, amylin (AMY) acts as a hormone that alters physiological responses related to feeding, and plays a role As a growth factor in bone. In vitro AMY stimulates the proliferation of osteoblasts, and osteoclast differentiation. Here we summarize the evidence that links energy expenditure and bone remodeling, with particular regard to humans.
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