Bone marrow adipose tissue (BMAT) has been considered for several decades as a silent bystander that fills empty space left in bone marrow following age-related decrease in hematopoiesis. However, recently new discoveries revealed BMAT as a secretory and metabolically active organ contributing to bone and whole-body energy metabolism. BMAT exhibits metabolic functions distinct from extramedullary adipose depots, relevant to its role in regulation of energy metabolism and its contribution to fracture risk observed in metabolic bone diseases. This review discusses novel insights of BMAT with particular emphasis on its contribution to the regulation of bone homeostasis. We also discuss the role of BMAT in regulation of fuel utilization and energy use that affect skeletal stem cell functions.

Molecular Endocrinology and Stem Cell Research Unit Department of Endocrinology and Metabolism Odense University Hospital and Institute of Clinical Research University of Southern Denmark Denmark; Department of Cellular and Molecular Medicine Faculty of Health Sciences University of Copenhagen Copenhagen Denmark

Molecular Physiology of Bone Institute of Physiology of the Czech Academy of Sciences Prague Czech Republic

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