Molecular mechanism of icariin in prevention and treatment of osteoporosis

• Icariin enhances osteogenic differentiation and bone formation by upregulating alkaline phosphatase, osteocalcin, and key transcription factors such as core binding factor α1 and bone morphogenetic proteins. • Icariin modulates multiple signaling pathways, including Wnt/β-catenin, MAPK, PI3K/Akt, OPG/RANKL/RANK, and Notch, to regulate the osteoblast-osteoclast balance. • Icariin promotes fracture healing by increasing serum markers of bone turnover and osteocalcin secretion at the fracture site. • Icariin exerts anti-osteoporotic effects through multidimensional mechanisms, including regulation of mRNA expression, oxidative stress inhibition, and improvement of the inflammatory microenvironment.