A Review of the Relationship Between Insulin and Bone Health

Insulin, a key hormone primarily involved in glucose metabolism, has emerged as a crucial modulator of bone metabolism. Increasing evidence suggests that insulin influences bone health, but its precise mechanism of action remains unestablished. This review explores the intricate relationship between...

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Main Authors: Sivasree Ravindran, Sok Kuan Wong, Nur-Vaizura Mohamad, Kok-Yong Chin
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/13/6/1504
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author Sivasree Ravindran
Sok Kuan Wong
Nur-Vaizura Mohamad
Kok-Yong Chin
author_facet Sivasree Ravindran
Sok Kuan Wong
Nur-Vaizura Mohamad
Kok-Yong Chin
author_sort Sivasree Ravindran
collection DOAJ
description Insulin, a key hormone primarily involved in glucose metabolism, has emerged as a crucial modulator of bone metabolism. Increasing evidence suggests that insulin influences bone health, but its precise mechanism of action remains unestablished. This review explores the intricate relationship between insulin and bone health, as well as elucidating the mechanism of action involved. Animal models of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) demonstrated distinct skeletal alterations, largely attributed to differences in insulin availability and associated metabolic dysfunction. Insulin deficiency in T1DM was associated with the deterioration of trabecular and cortical bone, whereas insulin resistance in T2DM primarily compromised trabecular bone quality. The route, frequency, and duration of insulin administration have been shown to influence bone-related outcomes. Studies involving insulin receptor silencing have suggested that insulin signalling is essential for normal bone development and maintenance. In humans, inconsistent findings on the effects of circulating insulin levels and insulin resistance on bone health were mainly attributed to heterogeneity in age, gender, metabolic status, study designs, population characteristics, and assessment methods. This review also highlights current knowledge gaps and underscores the need for longitudinal studies and mechanistic research. A clearer understanding of the insulin–bone axis may guide the development of targeted strategies to mitigate skeletal complications in individuals with diabetes mellitus.
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spelling doaj-art-e9d18c10468c4941bdb5094f2e772cfa2025-08-20T03:26:20ZengMDPI AGBiomedicines2227-90592025-06-01136150410.3390/biomedicines13061504A Review of the Relationship Between Insulin and Bone HealthSivasree Ravindran0Sok Kuan Wong1Nur-Vaizura Mohamad2Kok-Yong Chin3Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaDepartment of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaCentre for Drug and Herbal Development, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, MalaysiaDepartment of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, MalaysiaInsulin, a key hormone primarily involved in glucose metabolism, has emerged as a crucial modulator of bone metabolism. Increasing evidence suggests that insulin influences bone health, but its precise mechanism of action remains unestablished. This review explores the intricate relationship between insulin and bone health, as well as elucidating the mechanism of action involved. Animal models of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) demonstrated distinct skeletal alterations, largely attributed to differences in insulin availability and associated metabolic dysfunction. Insulin deficiency in T1DM was associated with the deterioration of trabecular and cortical bone, whereas insulin resistance in T2DM primarily compromised trabecular bone quality. The route, frequency, and duration of insulin administration have been shown to influence bone-related outcomes. Studies involving insulin receptor silencing have suggested that insulin signalling is essential for normal bone development and maintenance. In humans, inconsistent findings on the effects of circulating insulin levels and insulin resistance on bone health were mainly attributed to heterogeneity in age, gender, metabolic status, study designs, population characteristics, and assessment methods. This review also highlights current knowledge gaps and underscores the need for longitudinal studies and mechanistic research. A clearer understanding of the insulin–bone axis may guide the development of targeted strategies to mitigate skeletal complications in individuals with diabetes mellitus.https://www.mdpi.com/2227-9059/13/6/1504diabetes mellitusinsulinosteoblastosteoclastosteoporosis
spellingShingle Sivasree Ravindran
Sok Kuan Wong
Nur-Vaizura Mohamad
Kok-Yong Chin
A Review of the Relationship Between Insulin and Bone Health
Biomedicines
diabetes mellitus
insulin
osteoblast
osteoclast
osteoporosis
title A Review of the Relationship Between Insulin and Bone Health
title_full A Review of the Relationship Between Insulin and Bone Health
title_fullStr A Review of the Relationship Between Insulin and Bone Health
title_full_unstemmed A Review of the Relationship Between Insulin and Bone Health
title_short A Review of the Relationship Between Insulin and Bone Health
title_sort review of the relationship between insulin and bone health
topic diabetes mellitus
insulin
osteoblast
osteoclast
osteoporosis
url https://www.mdpi.com/2227-9059/13/6/1504
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