Table 2.

Representative clinical biomarkers and intervention strategies related to inflammation and oxidative stress in osteoporosis.

Biomarker/pathway	Type	Role in bone metabolism	Intervention strategy	Clinical stage	Reference
MDA (Malondialdehyde)	Oxidative stress marker	Lipid peroxidation product; elevated in high ROS states, linked to bone loss	Melatonin 20 mg/day for 12 months	RCT completed	(157)
8-OHdG	Oxidative DNA damage marker	Indicates oxidative DNA injury; correlated with bone resorption	Tocotrienol supplementation (300–600 mg/d)	Phase II RCT (NCT02058420)	(158)
sRANKL/OPG ratio	Osteoclast regulatory ratio	High ratio indicates enhanced osteoclast activation	Tocotrienol reduced the ratio in postmenopausal women	Phase II trial completed	(158)
TRACP 5b	Bone resorption marker	Reflects osteoclast activity	Vitamin B1 28 mg/day for 1 month	Pilot single-arm trial	(159)
β-CTX, P1NP	Bone turnover markers	β-CTX for resorption, P1NP for formation; used to monitor intervention response	Moderate static magnetic field (MMF) exposure	RCT completed (ChiCTR2100048604)	(160)
IL-1β, IL-6, TNF-α	Inflammatory cytokines	Promote osteoclastogenesis and bone resorption	Drynaria fortunei extract via NLRP3 inflammasome suppression	Preclinical/observational	(22)
NLRP3 inflammasome	Inflammatory pathway	Activates caspase-1 and IL-1β; central in inflammatory bone loss	Regulated via SIRT1/Notch1 signaling	Mechanistic/preclinical	(22)
18F-NaF PET SUVmean	Imaging biomarker	Reflects vertebral bone turnover activity; high values suggest metabolic dysfunction	Colchicine 0.5 mg/day for 3 months	2×2 factorial RCT	(161)

Summary of key inflammation and oxidative stress–related biomarkers and corresponding therapeutic strategies evaluated in clinical trials for osteoporosis. MDA, malondialdehyde; 8-OHdG, 8-hydroxy-2’-deoxyguanosine; RANKL, receptor activator of nuclear factor kappa-B ligand; OPG, osteoprotegerin; etc.