Research progress on effects of berberine on bone metabolism and related mechanisms

Osteoporosis is a common chronic disease in the elderly in China. With the acceleration of population aging, the prevalence of osteoporosis is gradually increasing. The prevalence of osteoporosis among people over 50 years old in China is 19.2%, and 32.0% for those over 65 years old. This not only results in an increasing number of elderly patients with fractures but also highlights the significant harm of osteoporosis due to the low awareness and treatment rate As a traditional Chinese medicine ingredient, berberine has been proven to be effective in treating a variety of chronic metabolic and inflammatory diseases, including diabetes, tumors, cardiovascular diseases, hyperlipidemia, inflammation, bacterial and viral infections, and osteoporosis. In terms of bone metabolism, berberine has shown certain improvements in both primary osteoporosis caused by menopause and secondary osteoporosis caused by multiple factors such as diabetes, obesity, and the use of glucocorticoids. Meanwhile, berberine has also shown strong bone regeneration ability in the study of bone defect repair under conditions of diabetes, local infection, and inflammation. Multiple in vivo and in vitro studies have shown that berberine can not only promote the differentiation and maturation of osteoblasts through classical signaling pathways such as Wnt/β‑catenin, PI3K/AKT, APK, and AMPK, but also effectively inhibit the differentiation and activity of osteoclasts by suppressing the RANKL signaling pathway. At the same time, berberine can also improve the oxidative stress state of tissues and regulate bone metabolism by regulating small non‑coding RNAs (miRNAs). This paper focuses on the mechanisms and research progress of berberine in osteogenesis and osteoclastogenesis, aiming to provide a reference for further in‑depth research on the mechanism of berberine in treating osteoporosis.