New understanding of how osteoporosis develops and personalized treatment approaches

Osteoporosis may be driven by diverse pathophysiological mechanisms, highlighting its heterogeneous nature.

• Subtypes of osteoporosis, such as those linked to postmenopausal estrogen deficiency and anorexia nervosa, show distinct patterns in bone turnover and fracture risk.
• Bone marrow adipose tissue is identified as a key regulator of the marrow environment in cases of postmenopausal and age-related bone loss.
• Various types of weight loss, including that from anorexia and GLP-1 receptor agonists, could negatively impact bone health through multiple pathways, including hormonal changes and reduced mechanical loading.
• Parathyroid hormone has dual effects on bone, where continuous exposure may lead to bone loss, while intermittent stimulation may promote bone formation.
• Exercise can benefit bone health through mechanisms such as mechanical loading and hormonal changes, with varying effects depending on the type and combination of exercise.

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