Osteoporosis is the prevalent metabolic bone disease characterized by a decrease in bone quantity and/or quality and an increase in skeletal fragility, which increases susceptibility to fractures. Osteoporotic fractures severely affect the patients’ quality of life and mortality. A plethora of evidences have suggested that the alterations in gut microbiome are associated with the changes in bone mass and microstructure. We summarized pre-clinical and clinical studies to elucidate the underlying mechanism of gut microbiota in osteoporosis. Probiotics, prebiotics, and traditional Chinese medicine may reverse the gut microbiota dysbiosis and consequently improve bone metabolism. However, the causality of gut microbiota on bone metabolism need to be investigated more in depth. In the present review, we focused on the potential mechanism of the microbiota-gut-bone axis and the positive therapeutic effect of probiotics, prebiotics, and traditional Chinese medicine on osteoporosis. Overall, the current scientific literatures support that the gut microbiota may be a novel therapeutic target in treatment of osteoporosis and fracture prevention.

骨质疏松症是一种普遍存在的代谢性骨病，其特征是骨量和/或质量下降以及骨骼脆性增加，从而增加骨折的易感性。骨质疏松性骨折严重影响患者的生活质量和死亡率。大量证据表明，肠道微生物组的改变与骨量和微结构的变化有关。我们总结了临床前和临床研究，以阐明肠道菌群在骨质疏松症中的潜在机制。益生菌、益生元和中药可以逆转肠道菌群失调，从而改善骨代谢。然而，肠道微生物群对骨代谢的因果关系需要更深入地研究。在本次审查中，我们关注微生物群-肠道-骨轴的潜在机制以及益生菌、益生元和中药对骨质疏松症的积极治疗作用。总的来说，目前的科学文献支持肠道微生物群可能是治疗骨质疏松症和预防骨折的新治疗靶点。