Obesity is associated with suppressed bone turnover: a systematic review and meta-analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Obesity is an increasingly serious public health issue on a global scale. Although there is increasing research on the relationship between obesity and biochemical markers of bone turnover, this relationship is complex and unclear. We conducted a systematic review and meta-analysis aimed at comparing the concentrations of biochemical markers of bone turnover between individuals with obesity and those with normal-weight. Method A systematic search was conducted using the PubMed, EMBASE, Web of Science, Cochrane Library, and EBSCO databases from database inception to December 15, 2025. Two researchers screened the literature according to the inclusion and exclusion criteria and extracted valid data for quality evaluation. Results The results ultimately included 14 articles with a total of 4612 subjects. Compared with normal-weight individuals, individuals with obesity showed no significant difference in alkaline phosphatase (ALP) levels. Procollagen type I N-terminal propeptide (PINP) levels were significantly reduced in individuals with obesity. Osteocalcin (OCN) levels were also decreased overall, but subgroup analysis showed that this reduction was significant in children and adolescents, whereas no significant difference was observed in adults. No significant difference was observed in C-terminal telopeptide of type I collagen (CTX-I) or N-terminal telopeptide of t

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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