The literature reports indicating a link between plasma levels of adiponectin and body fat, bone mineral density, sex hormones, and peri- and postmenopausal changes, draw attention to the possible use of adiponectin as an indicator of osteoporotic changes, suggesting that adiponectin may also modulate bone metabolism. In this study, we attempted to analyze the available in vitro and in vivo results which could verify this hypothesis. Although several studies have shown that adiponectin has an adverse effect on bone mass, mainly by intensifying resorption, this peptide has also been demonstrated to increase the proliferation and differentiation of osteoblasts, inhibit the activity of osteoclasts, and reduce bone resorption. There are still many ambiguities; for example, it can be assumed that concentrations of adiponectin in plasma do not satisfactorily reflect its production by adipose tissue, as well as conflicting in vitro and in vivo results. It seems that the potential benefit in the treatment of patients with osteoporosis associated with the pharmacological regulation of adiponectin is controversial. 1. Introduction Although the main role of adipose tissue is energy storage (in the form of free or conducted fatty acids (FFAs)) and thermal protection of the human body, it has been revealed that adipose tissue has an independent endocrine and paracrine activity associated with the production of many bioactive molecules (adipokines) which influence metabolic processes, such as adiponectin (Figure 1) [1]. Figure 1: Examples of adipocyte-derived proteins with effect on bone structure. It has also been shown that metabolites secreted by white adipose tissue (WAT) and brown adipose tissue (BAT) may play an essential role in maintaining normal body weight (regulation of body energy) and that they may participate in maintaining homeostasis, for example, through the prevention of insulin resistance [2, 3]. This may lead to the potential use of these substances as important markers in the prediction of many diseases. The potential role of adiponectin in diagnostics is associated with protection against atherogenesis, insulin resistance, and obesity and as a possible marker of risk for developing menopausal metabolic syndrome [4–11]. But only a few cross-sectional studies have been performed on the association between serum adiponectin concentrations and bone turnover and bone remodeling markers in humans in vitro as well as that clinical studies have shown that serum adiponectin levels are associated with bone mineral density (BMD) and as biochemical markers
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