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Cited by 66Bone health and osteoporosis researchBone Metabolism and DiseasesStress Responses and Cortisol

Potential mechanisms linking psychological stress to bone health

Open access
Ng, Jia-Sheng, Chin, Kok-Yong·2021·International Journal of Medical Sciences
DOI 10.7150/ijms.50680PMC PMC7797546
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Abstract

Chronic psychological stress affects many body systems, including the skeleton, through various mechanisms. This review aims to provide an overview of the factors mediating the relationship between psychological stress and bone health. These factors can be divided into physiological and behavioural changes induced by psychological stress. The physiological factors involve endocrinological changes, such as increased glucocorticoids, prolactin, leptin and parathyroid hormone levels and reduced gonadal hormones. Low-grade inflammation and hyperactivation of the sympathetic nervous system during psychological stress are also physiological changes detrimental to bone health. The behavioural changes during mental stress, such as altered dietary pattern, cigarette smoking, alcoholism and physical inactivity, also threaten the skeletal system. Psychological stress may be partly responsible for epigenetic regulation of skeletal development. It may also mediate the relationship between socioeconomic status and bone health. However, more direct evidence is required to prove these hypotheses. In conclusion, chronic psychological stress should be recognised as a risk factor of osteoporosis and stress-coping methods should be incorporated as part of the comprehensive osteoporosis-preventing strategy.

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  • Chronic stress reduces BMD.

    “Chronic stress further compounds this burden by reducing BMD [74]”

    From Interorgan Communications in Skeletal Pathophysiology: From Molecular Pathways to Multidisciplinary Therapies (2026) · cites this paper as [74]

    The Introduction reports an association between moderate-to-severe perceived stress and lower BMD in men, while the physiological-factors section describes a mechanism by which chronic mild stress caused bone loss. But the Conclusion says the causal relationship between psychological stress and BMD still needs investigation. The unqualified claim that chronic stress reduces BMD states causation more firmly than the review supports. (LLM, conf=0.87)

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Cited by

Sorted by citations

Authors
Ng, J.-S., & Chin, K.-Y.
Affiliations
National University of Malaysia (MY)
Corresponding author
Chin, Kok-Yong
ORCID
Chin, Kok-Yong
Venue
International Journal of Medical Sciences
Publisher
Ivyspring International Publisher
Published
2021
Volume
18
Issue
3
Pages
604-614
ISSN
1449-1907 (ISSN-L)
DOI
10.7150/ijms.50680
PMC
PMC7797546
OpenAlex
W3111287774
Cited by
66
References
15
Citations by year
2026: 20 · 2025: 17 · 2024: 13 · 2023: 5 · 2022: 6 · 2021: 5
FWCI
0.79
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • International Journal of Medical Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Universiti Kebangsaan Malaysia (FF-2018-405)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
psychological stress, bone health, osteoporosis, glucocorticoids, prolactin, leptin, parathyroid hormone, gonadal hormones, low-grade inflammation, sympathetic nervous system, dietary habits, smoking, alcoholism, physical inactivity, epigenetic regulation, socioeconomic status, stress coping
MeSH terms
Cigarette Smoking, Adaptation, Psychological, Alcoholism, Animals, Bone and Bones, Bone Development, Feeding Behavior, Glucocorticoids, Humans, Osteoporosis, Parathyroid Hormone, Prolactin, Risk Factors, Stress, Psychological, Bone Density, Leptin, Models, Animal, Epigenesis, Genetic

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