The bone-heart axis: A crucial dialogue in cardiovascular disease

  • Metabolism. 2025 Sep:170:156332. doi: 10.1016/j.metabol.2025.156332.
Ying Liu  1 ,  Qi Yao  1 ,  Jiabin Yu  1 ,  Yadan Zhang  1 ,  Yang Xiao  1 ,  Nan Zhang  1 ,  Qi-Zhu Tang  2
Affiliations
  • 1. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, PR China.
  • 2. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, PR China. Electronic address: [email protected].
PMID: 40543811 DOI: 10.1016/j.metabol.2025.156332
Abstract

Cardiovascular diseases (CVDs), the leading cause of global mortality, are now understood to be profoundly influenced by the endocrine regulatory functions of the skeletal system. Emerging evidence suggests that osteocrine factors, including fibroblast growth factor-23 (FGF23), lipocalin-2 (LCN2), Dickkopf-1 (DKK1), myeloid-derived growth factor (MYDGF), osteocalcin (OCN), and sclerostin (SOST), establish bidirectional regulatory networks with the cardiovascular system, termed the "bone-heart axis". This axis regulates critical pathological processes, including Mineral Metabolism, vascular calcification, and myocardial energy homeostasis. Dysregulation of this crosstalk accelerates the progression of Atherosclerosis (AS), Heart Failure (HF), and other CVDs. Therefore, current research necessitates a paradigm shift from univariate analyses to elucidating the spatiotemporal dynamics of interorgan communication, thereby facilitating the development of precision therapeutic strategies for integrated skeletal and cardiovascular protection.

Keywords
Bone-heart axis; Cardiovascular disease; FGF23; Metabolic-inflammatory networks; SOST.