Understanding insulin resistance in osteosarcopenic obesity: Therapeutic approaches for prevention and management.

Osteosarcopenic obesity (OSO) is a multifaceted condition in which obesity is present along with reduction in bone and muscle mass. The coexistence of these conditions increases the risk of fractures, physical disability and insulin resistance. This article explains the mechanism of insulin resistance in individuals with OSO highlighting the role of adipokines, lipid metabolites, pro inflammatory cells like Tumor Necrosis Factor-alpha, Interluekin-6, Interleukin-1 in causing the defective insulin signaling and exacerbating insulin resistance. The pathophysiology involves muscle atrophy and bone loss exacerbated by insulin resistance. Life style interventions like low resistance exercise and intake of diet full of nutrients especially proteins can be helpful in preventing this condition. A combination therapy of resistance trainings and protein rich diet can be considered as effective approach in combating OSO and improving insulin signaling. This article accentuates the importance of lifestyle and dietetic alterations in addressing OSO and its associated metabolic and hormonal disturbances.