Insulin like growth factor – insulin like growth factor binding protein family in osteoporosis: mechanistic and clinical insights

Introduction The imbalance between osteoblasts and osteoclasts is central to osteoporosis.Insulin like growth factor (IGF) has protective effects on bone. As an IGF-binding protein, the role of IGFBP in bone has also begun to come into the public’s view. IGFBP not only serves as an IGF reservoir but also acts independently, interacting with other ligands to regulate cell proliferation and differentiation. Due to the complexity of the molecular network of IGF-IGFBP, the specific mechanism by which IGF-IGFBP affects bone is still unknown. This review introduces the IGF-IGFBP network and its roles in osteogenesis and osteoclast differentiation, and explores its potential as a novel therapeutic target for osteoporosis.Method Relevant studies were identified in PubMed and Web of Science using the keywords ‘IGFBP’, ‘Bone’, and ‘Osteoporosis’, followed by a comprehensive review of the literature.Results IGF-IGFBP regulates bone metabolism by modulating the differentiation of bone marrow mesenchymal stem cells (BMSCs) into osteogenic and adipogenic lineages, as well as the differentiation process of osteoclasts. Current studies mainly focuson osteogenic differentiation, while research on adipogenic and osteoclastogenic differentiationis limited. Some IGFBP molecules show inhibitory effects in osteogenesis, but their detailed molecular mechanisms are not fully elucidated.Conclusion The IGF-IGFBP family influences bone metabolism through multiple biological pathways. However, the precise molecular mechanisms by which this system regulates bone metabolism remain incompletely understood. Future studies are needed to systematically elucidate its functional networks and pathophysiological significance in bone metabolism.