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World J Diabetes. Jul 15, 2026; 17(7): 119692
Published online Jul 15, 2026. doi: 10.4239/wjd.119692
Published online Jul 15, 2026. doi: 10.4239/wjd.119692
Diabetic osteoporosis: Focus on ferroptosis as a key player and future prospect in traditional Chinese medicine
Xin-Ran Geng, The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang 110874, Liaoning Province, China
Yang Liu, Department of Endocrinology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Co-first authors: Xin-Ran Geng and Yang Liu.
Author contributions: Geng XR and Liu Y made equal contributions as co-first authors; Geng XR contributed to conceptualization, literature search and collection, manuscript writing and original draft preparation; Liu Y contributed to supervision, manuscript review and editing, and critical revision of the article for important intellectual content. Both authors have read and agreed to the published version of the manuscript.
AI contribution statement: No ChatGPT, Grammarly, DeepL, or any other artificial intelligence tool was involved in the generation of any part of the main text of this manuscript; the entire content was independently conceived and written by the authors. AI tools were not applied to data analysis or core academic writing. In addition, no artificial intelligence tool participated in the study design or result interpretation, and none of the images included in the manuscript were AI-generated.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Yang Liu, Chief Physician, Department of Endocrinology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, No. 33 Beiling Street, Huanggu District, Shenyang 110032, Liaoning Province, China. liuyang_linda@163.com
Received: February 3, 2026
Revised: March 23, 2026
Accepted: May 18, 2026
Published online: July 15, 2026
Processing time: 156 Days and 14 Hours
Revised: March 23, 2026
Accepted: May 18, 2026
Published online: July 15, 2026
Processing time: 156 Days and 14 Hours
Core Tip
Core Tip: Diabetic osteoporosis (DOP) poses high disability and fracture risks, with high-glucose-induced bone cell ferroptosis (driven by iron overload, lipid peroxidation and system Xc-/glutathione/glutathione peroxidase 4 imbalance) as its core pathogenesis. Western medicine cannot synergistically improve glucose and bone metabolism and has side effects. This minireview focuses on the high-glucose-bone cell ferroptosis-DOP axis, clarifies ferroptosis mechanisms in key bone cells, and describes how traditional Chinese medicine (TCM) targets ferroptosis via multiple pathways to treat DOP. We bridge TCM theory and the molecular mechanisms of ferroptosis, and discuss TCM-based DOP research directions and clinical translation.