The Role of Glucose Metabolic Reprogramming in Exercise-Attenuated Osteoporosis: a Narrative Review

The aging population has led to a significant increase in the prevalence of osteoporosis, making it an important public health issue. Emerging evidence suggests that osteoporosis is related to glucose metabolic reprogramming (GMR). Exercise is an effective non-pharmacological intervention method, and regulating GMR may be one of the pathways through which exercise improves bone health.

GMR plays a critical role in regulating the function of bone cells. It influences the proliferation and differentiation of bone marrow mesenchymal stem cells (BMSCs), osteoblasts, osteocytes, and osteoclasts. Although the exact mechanisms remain to be fully elucidated, emerging studies suggest that metabolic shifts in glycolysis, the pentose phosphate pathway (PPP), and the tricarboxylic acid (TCA) cycle are critical regulators of bone homeostasis. Furthermore, preliminary evidence suggests that exercise modulates these metabolic pathways, thereby contributing to improved bone health and reduced osteoporotic risk.

This narrative review provides new insights into the mechanistic understanding that GMR plays essential roles in the initiation and progression of osteoporosis. Different types of exercise may attenuate osteoporosis through the regulation of GMR.