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      Osteoporosis and sarcopenia: two diseases or one?

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose of review

          This article reviews recently published evidence for common pathways explaining bone and muscle wasting in normal ageing and pathological conditions.

          Recent findings

          Numerous studies support the concept of a bone–muscle unit, where constant cross-talking between the two tissues takes place, involving molecules released by the skeletal muscle secretome, which affects bone, and osteokines secreted by the osteoblasts and osteocytes, which, in turn, impact muscle cells.

          Summary

          New chemical entities aiming at concomitantly treating osteoporosis and sarcopenia could be developed by targeting pathways that centrally regulate bone and muscle or emerging pathways that facilitate the communication between the two tissues.

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          Most cited references23

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          European guidance for the diagnosis and management of osteoporosis in postmenopausal women

          Summary Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk of fractures due to osteoporosis. Introduction The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2008. This manuscript updates these in a European setting. Methods Systematic literature reviews. Results The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk, general and pharmacological management of osteoporosis, monitoring of treatment, assessment of fracture risk, case finding strategies, investigation of patients and health economics of treatment. Conclusions A platform is provided on which specific guidelines can be developed for national use.
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            Muscle and bone, two interconnected tissues.

            As bones are levers for skeletal muscle to exert forces, both are complementary and essential for locomotion and individual autonomy. In the past decades, the idea of a bone-muscle unit has emerged. Numerous studies have confirmed this hypothesis from in utero to aging works. Space flight, bed rest as well as osteoporosis and sarcopenia experimentations have allowed to accumulate considerable evidence. Mechanical loading is a key mechanism linking both tissues with a central promoting role of physical activity. Moreover, the skeletal muscle secretome accounts various molecules that affect bone including insulin-like growth factor-1 (IGF-1), basic fibroblast growth factor (FGF-2), interleukin-6 (IL-6), IL-15, myostatin, osteoglycin (OGN), FAM5C, Tmem119 and osteoactivin. Even though studies on the potential effects of bone on muscle metabolism are sparse, few osteokines have been identified. Prostaglandin E2 (PGE2) and Wnt3a, which are secreted by osteocytes, osteocalcin (OCN) and IGF-1, which are produced by osteoblasts and sclerostin which is secreted by both cell types, might impact skeletal muscle cells. Cartilage and adipose tissue are also likely to participate to this control loop and should not be set aside. Indeed, chondrocytes are known to secrete Dickkopf-1 (DKK-1) and Indian hedgehog (Ihh) and adipocytes produce leptin, adiponectin and IL-6, which potentially modulate bone and muscle metabolisms. The understanding of this system will enable to define new levers to prevent/treat sarcopenia and osteoporosis at the same time. These strategies might include nutritional interventions and physical exercise.
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              Interrelationship among muscle, fat, and bone: connecting the dots on cellular, hormonal, and whole body levels.

              While sarcopenia and sarcopenic obesity have been recognized in the last decade, a combined concept to include decreased muscle mass and strength, as well as decreased bone mass with coexistence of adiposity is discussed here. We introduce a new term, osteopenic obesity, and operationalize its meaning within the context of osteopenia and obesity. Next, we consolidate osteopenic obesity with the already existing and more familiar term, sarcopenic obesity, and delineate the resulting combined condition assigning it the term osteosarcopenic obesity. Identification and possible diagnosis of each condition are discussed, as well as the interactions of muscle, fat and bone tissues on cellular level, considering their endocrine features. Special emphasis is placed on the mesenchymal stem cell commitment into osteoblastogenic, adipogenic and myogenic lineages and causes of its deregulation. Based on the presented evidence and as expounded within the text, it is reasonable to say that under certain conditions, osteoporosis and sarcopenia could be the obesity of bone and muscle, respectively, with the term osteosarcopenic obesity as an encompassment for all.
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                Author and article information

                Journal
                Curr Opin Clin Nutr Metab Care
                Curr Opin Clin Nutr Metab Care
                COCNM
                Current Opinion in Clinical Nutrition and Metabolic Care
                Lippincott Williams & Wilkins
                1363-1950
                1473-6519
                January 2016
                03 December 2015
                : 19
                : 1
                : 31-36
                Affiliations
                [a ]Department of Public Health, Epidemiology and Health Economics
                [b ]Support Unit in Epidemiology and Biostatistics, University of Liège, Liège, Belgium
                Author notes
                Correspondence to Jean-Yves Reginster, MD, PhD, Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000 Liège, Belgium. Tel: +32 4 349 02 96; fax: +32 4 341 23 14; e-mail: jyreginster@ 123456ulg.ac.be
                Article
                00007
                10.1097/MCO.0000000000000230
                4888925
                26418824
                4f2aa14a-5361-4647-a7d9-b703a11f33f7
                Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                Categories
                AGEING: BIOLOGY AND NUTRITION: Edited bY Tommy Cederholm and John E. Morley
                Custom metadata
                TRUE

                bone,muscle,myostatin,osteoporosis,sarcopenia
                bone, muscle, myostatin, osteoporosis, sarcopenia

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