Advances in the Study of Denosumab Treatment for Osteoporosis and Sarcopenia in the Chinese Middle-Aged and Elderly Population

Shaotian Li,* Jingfeng Zou,* Jiajia Ran,* Liping Wang, Guqiao Nie, Yiting Liu, Chunhui Tian, Xin Yang, Yun Liu, Jingjing Wan, Wen Peng General Practice Department, Union Hospital TongJi Medical College HuaZhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wen Peng; Jingjing Wan, Union Hospital TongJi Medical College HuaZhong University of Science and Technology, 1277 Jiefang Avenue, Jianghan District, Wuhan City, Hubei Province, People’s Republic of China, Tel +86 13986074846, Email [email protected]; [email protected]: Osteosarcopenia (OS) is a geriatric syndrome characterized by the concurrent presence of osteoporosis and sarcopenia, predominantly affecting the elderly population. Osteoporosis (OP) is a systemic skeletal disorder characterized by decreased bone mass, compromised bone microarchitecture, and heightened bone fragility, substantially elevating fracture risk. Sarcopenia (SP) is defined by decreased muscle mass, strength, and/or functional capacity. Both conditions are age-related degenerative diseases with overlapping pathophysiological mechanisms, commonly co-occurring in elderly individuals and substantially increasing fracture risk. Denosumab, a targeted anti-osteoporotic agent, mediates therapeutic effects by inhibiting bone resorption through the RANK-RANKL-OPG (RRO) pathway, consequently enhancing bone mineral density. International studies indicate that Denosumab not only treats osteoporosis but also improves sarcopenia-related metrics, suggesting its potential as a sarcopenia treatment. However, research focusing on the Chinese population remains limited. Additionally, the pathophysiological mechanisms of sarcopenia and the pathways through which Denosumab ameliorates sarcopenia are not yet fully understood, warranting further experimental investigation. In summary, Denosumab’s therapeutic efficacy in osteoporosis treatment and its potential impact on sarcopenia are of substantial research interest. However, research and literature on these topics in China remain notably scarce. This article aims to offer a systematic review and critical analysis of these topics.Keywords: osteoporosis, sarcopenia, denosumab, RANK-RANKL-OPG pathway, comorbidity