Higher Bone Mineral Density in Obesity Masks Impaired Bone Remodeling and Disproportionate Musculoskeletal Adaptation in Young Women
- 1Laboratory of Cellular and Molecular Pharmacology, Department of Cell Biology, IBRAG Universidade do Estado do Rio de Janeiro (UERJ) Rio de Janeiro Brazil
- 2Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Department of Anatomy, IBRAG Universidade do Estado do Rio de Janeiro (UERJ) Rio de Janeiro Brazil
- 3Obesity Unit (SAI‐Ob), Multiuser Clinical Research Center (CePeM) Pedro Ernesto University Hospital (HUPE), Universidade do Estado do Rio de Janeiro (UERJ) Rio de Janeiro Brazil
Abstract
Obesity is a multifactorial disease characterized by excessive adiposity that influences bone remodeling through increased mechanical loading, chronic low‐grade inflammation, and sedentary behavior. While obesity is linked to structural skeletal changes, its precise impact on bone mineral density (BMD) and bone remodeling in humans remains controversial, particularly in young women. This is particularly relevant because the majority of studies have investigated young women, in whom many of the observed skeletal alterations are attributable to aging rather than obesity per se. This study investigated the impact of increased adiposity on total, lumbar spine, and femoral neck BMD in 54 young Brazilian women with 18–40 years. Body composition and BMD were assessed by DXA, and plasma markers of bone formation and resorption were analyzed. Associations among adiposity, lean mass, BMD, and bone turnover markers were examined. Women with obesity exhibited higher total and regional BMD and greater lean mass than women without obesity. However, adjusting bone and lean mass for fat mass revealed a musculoskeletal imbalance. In addition, obesity was associated with a suppressed bone turnover profile; these women presented lower circulating levels of the formation markers P1NP and osteocalcin, alongside elevated resorption markers CTX‐I and RANK‐L/OPG. Ultimately, these findings demonstrate that bone remodeling is compromised despite an apparent increase in bone mass. Obesity in young Brazilian women is associated with higher BMD and lean mass; however, these findings may mask underlying detrimental alterations in bone remodeling. The observed imbalance between bone formation and resorption demonstrates that increased density does not reflect improved skeletal health, but rather compromised bone quality and structural fragility.
Related
- Bone Mineral Density Distribution and Microstructural Bone Remodeling in Health and Disease
- Chronic Energy Restriction Is Associated with Impaired Follicular Development and Hepatic Bile Acid Remodeling in Mice.
- PO135 | CHRONIC ERYTHROCYTE REMODELING AND IMPAIRED RHEOLOGICAL FUNCTION IN PATIENTS WITH PATENT FORAMEN OVALE
- Transient Splicing-Associated Isoform Remodeling Defines Early MAPKi Resistance Adaptation in Melanoma
- Inflammatory Burden Shapes Antioxidant Adaptation and Immunometabolic Remodeling in LPS-Activated BV-2 Microglial Cells
BibTeX
@article{forte2026higher,
title = {{Higher Bone Mineral Density in Obesity Masks Impaired Bone Remodeling and Disproportionate Musculoskeletal Adaptation in Young Women}},
author = {Yasmin Silva Forte and Caio Andrade‐Santos and Camila Pantoja‐Marinho and Luísa González‐Joaquim and Aline Penna‐De‐Carvalho and Paulo Roberto Falcão Leal and Karynne Grutter Lopes and Luiz Guilherme Kraemer‐Aguiar and Christina Barja‐Fidalgo},
journal = {The FASEB Journal},
year = {2026},
month = oct,
doi = {10.1096/fj.202603540r},
url = {https://doi.org/10.1096/fj.202603540r},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Higher Bone Mineral Density in Obesity Masks Impaired Bone Remodeling and Disproportionate Musculoskeletal Adaptation in Young Women
AU - Yasmin Silva Forte
AU - Caio Andrade‐Santos
AU - Camila Pantoja‐Marinho
AU - Luísa González‐Joaquim
AU - Aline Penna‐De‐Carvalho
AU - Paulo Roberto Falcão Leal
AU - Karynne Grutter Lopes
AU - Luiz Guilherme Kraemer‐Aguiar
AU - Christina Barja‐Fidalgo
PY - 2026
DA - 2026/10/27
JO - The FASEB Journal
DO - 10.1096/fj.202603540r
UR - https://doi.org/10.1096/fj.202603540r
AB - Obesity is a multifactorial disease characterized by excessive adiposity that influences bone remodeling through increased mechanical loading, chronic low‐grade inflammation, and sedentary behavior. While obesity is linked to structural skeletal changes, its precise impact on bone mineral density (BMD) and bone remodeling in humans remains controversial, particularly in young women. This is particularly relevant because the majority of studies have investigated young women, in whom many of the observed skeletal alterations are attributable to aging rather than obesity per se. This study investigated the impact of increased adiposity on total, lumbar spine, and femoral neck BMD in 54 young Brazilian women with 18–40 years. Body composition and BMD were assessed by DXA, and plasma markers of bone formation and resorption were analyzed. Associations among adiposity, lean mass, BMD, and bone turnover markers were examined. Women with obesity exhibited higher total and regional BMD and greater lean mass than women without obesity. However, adjusting bone and lean mass for fat mass revealed a musculoskeletal imbalance. In addition, obesity was associated with a suppressed bone turnover profile; these women presented lower circulating levels of the formation markers P1NP and osteocalcin, alongside elevated resorption markers CTX‐I and RANK‐L/OPG. Ultimately, these findings demonstrate that bone remodeling is compromised despite an apparent increase in bone mass. Obesity in young Brazilian women is associated with higher BMD and lean mass; however, these findings may mask underlying detrimental alterations in bone remodeling. The observed imbalance between bone formation and resorption demonstrates that increased density does not reflect improved skeletal health, but rather compromised bone quality and structural fragility.
SN - 0892-6638
SN - 1530-6860
ER -