Tissue-specific mechanism of estrogen in osteoporosis and vascular calcification

Vascular calcification and osteoporosis are interrelated diseases, with estrogen being the key link between them. Estrogen binds to receptors in cells, triggering various signaling pathways, which is its primary mode of action. Additionally, estrogen can interact with other macromolecules in the environment, influencing both vascular calcification and osteoporosis. Environmental cholesterol and vitamin D are directly or indirectly related to estrogen in ways that affect these conditions. Collagen and elastin, critical components of the extracellular matrix, significantly influence vascular calcification and osteoporosis. There is a potential link between estrogen and these proteins in inhibiting these diseases. Physical stimuli can also affect the regulation of estrogen on vascular calcification and osteoporosis. Current research has mainly focused on estrogen and its receptors, while the roles of macromolecules, collagen, elastin, and physical stimuli have not been thoroughly studied. Furthermore, the effects of different forms of estrogen (estradiol, estriol, and estrone) on various genders and tissues require further investigation to develop targeted therapies and deepen our understanding of gender differences in these diseases.