Evidence map›Paper›PMID 34948466›Full record

ReviewInternational journal of molecular sciences2021

Obesity and Bone: A Complex Relationship.

Giuseppe Rinonapoli, Valerio Pace, Carmelinda Ruggiero, Paolo Ceccarini, Michele Bisaccia, Luigi Meccariello, Auro Caraffa

Registry-linked trialOpen access · goldAbstract readReview
In one paragraph

Review in International journal of molecular sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07094568 (Comparative Investigation of Changes in Body Composition and Bone Turnover Markers in People With Obesity After Treatment With Tirzepatide Versus Liraglutide. A Prospective Cohort Study.), which is not on this map. Cited by 162 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
162citing papers in PubMed, 6 pooled it
24.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07094568 recruitingnot on this mapstarted 2025, after this paper: background citation

Comparative Investigation of Changes in Body Composition and Bone Turnover Markers in People With Obesity After Treatment With Tirzepatide Versus Liraglutide. A Prospective Cohort Study.

TypeobservationalSponsorNational and Kapodistrian University of AthensRan2025 to 2026Enrolled72ConditionsObesity (Disorder)
3 · Its place in the literature

Who cites it

162 citing papers in PubMed, 6 syntheses or guidelines pooled it, 242 citations in OpenAlex.

  1. Pooled it
  2. Obesity and long bone fractures in children. Systematic review.Archives of orthopaedic and trauma surgery · 2026
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. A randomized, double-blind, placebo-controlled clinical study to evaluate the efficacy of the synbiotic medical food, SBD111, for the clinical dietary management of bone loss in menopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Trial
  8. Article
  9. Article
  10. Review
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  12. Diagnosis, treatment, and management recommendations for cleidocranial dysplasia: A modified Delphi panel.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026
    Article
  13. Observational
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

102 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Giuseppe RinonapoliOrthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy.ORCID 0000-0002-4244-166X
Valerio PaceOrthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy.ORCID 0000-0002-4499-9157
Carmelinda RuggieroOrthogeriatric Service, Geriatric Unit, Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy.ORCID 0000-0002-1245-1963
Paolo CeccariniOrthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy.
Michele BisacciaDepartment of Orthopaedics and Traumatology, AORN San Pio "Gaetano Rummo Hospital", Via R.Delcogliano, 82100 Benevento, Italy.
Luigi MeccarielloDepartment of Orthopaedics and Traumatology, AORN San Pio "Gaetano Rummo Hospital", Via R.Delcogliano, 82100 Benevento, Italy.
Auro CaraffaOrthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy.
University of Perugia · ITAzienda Ospedaliera G.Rummo · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is a large literature on the relationship between obesity and bone. What we can conclude from this review is that the increase in body weight causes an increase in BMD, both for a mechanical effect and for the greater amount of estrogens present in the adipose tissue. Nevertheless, despite an apparent strengthening of the bone witnessed by the increased BMD, the risk of fracture is higher. The greater risk of fracture in the obese subject is due to various factors, which are carefully analyzed by the Authors. These factors can be divided into metabolic factors and increased risk of falls. Fractures have an atypical distribution in the obese, with a lower incidence of typical osteoporotic fractures, such as those of hip, spine and wrist, and an increase in fractures of the ankle, upper leg, and humerus. In children, the distribution is different, but it is not the same in obese and normal-weight children. Specifically, the fractures of the lower limb are much more frequent in obese children. Sarcopenic obesity plays an important role. The authors also review the available literature regarding the effects of high-fat diet, weight loss and bariatric surgery.

Indexed as

Body Mass IndexBody WeightFractures, BoneHumansObesityRisk Factorsbone fragilityfractureobese fracture site paradoxobesityosteoporosis

Identifiers

PMID34948466
PMCPMC8706946
OpenAlexW4200341604

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.