2024, Vol. 28 ›› Issue (26): 4250-4256

Intestinal flora and osteoporosis and exercise intervention

Yang Qihang1, Pu Rui1, 2, Chen Ziyang1, 2, Leng Siyi1, Song Yongjing1, Liu Hui3, Du Guangyou1   

Abstract: BACKGROUND: Intestinal flora and its metabolites can participate in the pathological process of osteoporosis and play an important role in the diagnosis and treatment of osteoporosis. In addition, exercise can regulate the intestinal flora and thus affect the occurrence and development of osteoporosis.
OBJECTIVE: To summarize the effects and mechanism of intestinal flora on osteoblasts, osteoclasts, and bone marrow mesenchymal stem cells, and the potential role of exercise-mediated intestinal flora in regulating osteoporosis.
METHODS: “Intestinal flora, intestinal bacteria, metabolites of intestinal flora, bone metabolism, osteoporosis, exercise” were selected as keywords. Literatures from 1990 to 2023 were retrieved from PubMed and CNKI databases.
RESULTS AND CONCLUSION: Changes in the abundance and diversity of intestinal flora and changes in the levels of intestinal flora metabolites such as trimethylamine oxide and bile acid can be used as biomarkers for the diagnosis of osteoporosis. The imbalance of intestinal flora can lead to intestinal barrier dysfunction and excessive production of lipopolysaccharides and trimethylamine oxide, induce the secretion of tumor necrosis factor-α and other inflammatory cytokines, activate the nuclear factor κB signaling pathway and aggravate oxidative stress, thus promoting osteoclast differentiation, inducing osteoblast apoptosis and affecting bone marrow mesenchymal cell migration. Remodeling intestinal flora homeostasis can inhibit inflammatory response, downregulate oxidative stress, inhibit osteoclast differentiation, promote osteoblast differentiation, and regulate the osteogenic migration of bone marrow mesenchymal cells to prevent and treat osteoporosis. Exercise can regulate intestinal flora homeostasis, improve intestinal barrier function, promote the secretion of short-chain fatty acids and bile acids, down-regulate serum lipopolysaccharide level, reduce oxidative stress, and then inhibit osteocyte apoptosis, inhibit osteoclast differentiation, promote osteoblast differentiation, and regulate osteocyte nutrient metabolism to exert the potential of preventing and treating osteoporosis.

Key words: intestinal flora, intestinal bacteria, metabolites of intestinal flora, bone metabolism, osteoporosis, exercise