Adiponectin is the most abundant circulating adipokine and is primarily involved in glucose metabolism and insulin resistance. Within the bone, osteoblasts and osteoclasts express the adiponectin receptors, however, there are conflicting reports on the effects of adiponectin on bone formation and turnover. Many studies have shown a pro-osteogenic role for adiponectin in in vivo murine models and in vitro: with increased osteoblast differentiation and activity, alongside lower levels of osteoclastogenesis. However, human studies often demonstrate an inverse relationship between adiponectin concentration and bone activity. Moreover, the presence of multiple isoforms of adiponectin and multiple receptor subtypes has the potential to lead to more complex signalling and functional consequences. As such, we still do not fully understand the importance of the adiponectin signalling pathway in regulating bone homeostasis and repair in health, with age and in disease. In this review, we explore our current understanding of adiponectin bioactivity in the bone; the significance of its different isoforms; and how adiponectin biology is altered in disease. Ultimately, furthering our understanding of adiponectin regulation of bone biology is key to developing pharmacological and non-pharmacological (lifestyle) interventions that target adiponectin signalling to boost bone growth and repair in healthy ageing, following injury or in disease.

脂联素是最丰富的循环脂肪因子，主要参与葡萄糖代谢和胰岛素抵抗。在骨内，成骨细胞和破骨细胞表达脂联素受体，然而，关于脂联素对骨形成和更新的影响的报道相互矛盾。许多研究表明，脂联素在小鼠体内和体外模型中具有促成骨作用：成骨细胞分化和活性增加，同时破骨细胞生成水平较低。然而，人体研究经常证明脂联素浓度与骨活性之间存在反比关系。此外，多种脂联素亚型和多种受体亚型的存在有可能导致更复杂的信号传导和功能后果。像这样，我们仍然不完全了解脂联素信号通路在调节骨稳态和修复健康、年龄和疾病方面的重要性。在这篇综述中，我们探讨了我们目前对骨骼中脂联素生物活性的理解；其不同异构体的重要性；以及脂联素生物学如何在疾病中发生改变。最终，加深我们对脂联素对骨生物学调节的理解是开发药理学和非药理学（生活方式）干预措施的关键，这些干预措施以脂联素信号为目标，以促进健康衰老、受伤后或疾病中的骨骼生长和修复。其不同异构体的重要性；以及脂联素生物学如何在疾病中发生改变。最终，加深我们对脂联素对骨生物学调节的理解是开发药理学和非药理学（生活方式）干预措施的关键，这些干预措施以脂联素信号为目标，以促进健康衰老、受伤后或疾病中的骨骼生长和修复。其不同异构体的重要性；以及脂联素生物学如何在疾病中发生改变。最终，加深我们对脂联素对骨生物学调节的理解是开发药理学和非药理学（生活方式）干预措施的关键，这些干预措施以脂联素信号为目标，以促进健康衰老、受伤后或疾病中的骨骼生长和修复。