Additional opportunities exist to identify the onset, cause, and effect of this condition. Although osteosarcopenic obesity leads to health complications (Fig. 1), it is unclear if the health implications are a cause or consequence of osteosarcopenic obesity (Fig. 2). In fact, further studies are needed to investigate the occurrence of potential reverse causality. Importantly, although future studies are needed, we anticipate that this combined phenotype will represent an advantage for risk prediction and preventive/treatment strategies in primary and secondary/tertiary care.
Fig. 2 Hypothesized interrelationships between bone, muscle, and adipose tissue in the osteosarcopenic syndrome. IMAT, intramuscular adipose tissue; GH, growth hormone; IGF, insulin-like growth factor I; ROS, reactive oxygen species. Adapted from Zamboni et al. [35], Ezzat-Zadeh et al. [44], and Roubenoff [33]