Osteoporosis is a systemic bone disease that affects more than 200 million people worldwide and is caused by the disruption of the equilibrium between osteoclastic bone resorption and osteoblastic bone formation. Sphingosine-1-phosphate (S1P) is a natural, bioactive sphingolipid that has been shown to play a major role in cardiovascular and immunological pathologies by regulating biological and cellular processes, including migration, differentiation, proliferation and survival. Recent studies also suggest a central role for S1P in bone diseases, including osteoporosis; however, the effects of S1P, particularly in bone metabolism, remain to be further elucidated. In this review, we summarize the available literature on the role of S1P in bone metabolism with a focus on osteoporosis. On the cellular level, S1P acts as an osteoclast-osteoblast coupling factor to promote osteoblast proliferation and bone formation. Moreover, the recruitment of osteoclast precursors to resorption sites is regulated by the interplay of S1P gradients and S1P receptor expression. From a clinical perspective, increasing evidence suggests that systemically elevated S1P blood levels may serve as an independent risk factor for osteoporosis-related fractures. Taken together, S1P signaling is a potential therapeutic target and may serve as a novel biomarker in patients with systemic bone disease.

骨质疏松症是一种全身性骨病，影响全世界超过 2 亿人，是由破骨细胞骨吸收和成骨细胞骨形成之间的平衡破坏引起的。1-磷酸鞘氨醇 (S1P) 是一种天然的生物活性鞘脂，已被证明通过调节生物和细胞过程（包括迁移、分化、增殖和存活）在心血管和免疫病理学中发挥重要作用。最近的研究还表明 S1P 在包括骨质疏松症在内的骨骼疾病中的核心作用。然而，S1P 的影响，特别是在骨代谢中的影响，仍有待进一步阐明。在这篇综述中，我们总结了关于 S1P 在骨代谢中作用的现有文献，重点是骨质疏松症。在细胞水平上，S1P 作为破骨细胞-成骨细胞偶联因子，促进成骨细胞增殖和骨形成。此外，破骨细胞前体向吸收位点的募集受 S1P 梯度和 S1P 受体表达的相互作用调节。从临床角度来看，越来越多的证据表明全身性升高的 S1P 血液水平可能是骨质疏松症相关骨折的独立危险因素。总之，S1P 信号传导是一个潜在的治疗靶点，可作为全身性骨病患者的新型生物标志物。越来越多的证据表明，全身升高的 S1P 血液水平可能是骨质疏松症相关骨折的独立危险因素。总之，S1P 信号传导是一个潜在的治疗靶点，可作为全身性骨病患者的新型生物标志物。越来越多的证据表明，全身升高的 S1P 血液水平可能是骨质疏松症相关骨折的独立危险因素。总之，S1P 信号传导是一个潜在的治疗靶点，可作为全身性骨病患者的新型生物标志物。