SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
The Anti-Osteoporotic Effect of Puerarin on Femoral Bone in Rat Models of Osteoporosis: A Systematic Review and Meta-Analysis
Provisionally accepted
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Objective: This systematic review and meta-analysis aimed to evaluate the anti-osteoporotic efficacy of puerarin in rodent models of osteoporosis and to explore the impact of dosage, treatment duration and intervention Method. Methods: A comprehensive search of electronic databases (e.g., PubMed, EMBASE, Web of Science, CNKI, Wanfang) was conducted up to August 2025. Randomized controlled trials (RCTs) investigating the effects of puerarin monotherapy on osteoporotic rats were included. The primary outcome was bone mineral density (BMD), and secondary outcomes included bone histomorphometric parameters (BV/TV, Tb.Th, Tb.N, Tb.Sp) and bone turnover markers (e.g., PINP, BALP, CTX, TRACP, osteocalcin). Data were pooled using a random-effects model, and subgroup analyses were performed based on puerarin dose, treatment duration and intervention Method. Study quality was assessed using the SYRCLE risk of bias tool. Results: Twenty-eight studies involving 570 animals were included. The meta-analysis demonstrated that puerarin significantly increased femoral BMD (SMD = 2.95, 95% CI: 2.32 to 3.58, p < 0.00001) and improved bone microarchitecture by increasing BV/TV, Tb.Th, Tb.N, and decreasing Tb.Sp. Subgroup analysis revealed the most pronounced BMD improvement occurred at doses ≥50 mg/kg/day administered for ≥8 weeks. Puerarin significantly suppressed bone resorption markers, CTX and TRACP, and elevated serum levels of osteocalcin, calcium, and phosphorus. However, its effects on bone formation markers, PINP and BALP, were not statistically significant. Conclusion: Puerarin exhibits significant therapeutic potential for osteoporosis in rat models by increasing BMD, improving bone quality, and rebalancing bone metabolism in favor of formation, primarily through the inhibition of resorption. The optimal effect appears dose-and duration-dependent. While these preclinical findings are promising, the clinical translation of puerarin requires validation through larger-scale, high-quality animal studies and subsequent clinical trials.
Keywords: Puerarin, Osteoporosis, bone mineral density, Meta-analysis, Rats
Received: 25 Sep 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Yang, RUI, Ma, Luo and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yimei Hu
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