Antiosteoporosis Effect of Eucommia Ulmoides Cortex in Postmenopausal Osteoporosis Animal Models: A Systematic Review and Meta-Analysis

Postmenopausal osteoporosis (PMOP) poses substantial health risks, motivating interest in natural therapies. Here we systematically evaluated Eucommia ulmoides cortex (EUC), a traditional Chinese medicinal plant, in PMOP animal models. Meta-analysis of 14 studies comprising 343 ovariectomized rats showed that EUC markedly increased bone mineral density (standardized mean difference ( SMD ) = 2.16, 95% confidence interval ( CI ) = 1.63-2.69) and improved trabecular microarchitecture, including bone volume fraction ( SMD = 1.39, 95% CI = 0.85-1.94), trabecular number ( SMD = 4.33, 95% CI = 3.22-5.44) and trabecular thickness ( SMD = 2.25, 95% CI = 0.87-3.62), while reducing trabecular separation ( SMD = −4.87, 95% CI = −6.08 to −3.67). EUC also enhanced biomechanical strength ( SMD = 1.14, 95% CI = 0.68-1.60) and lowered serum alkaline phosphatase ( SMD = −1.66, 95% CI = −3.26 to −0.06), whereas serum osteocalcin was not significantly altered ( SMD = −0.42, 95% CI = −1.94 to 1.10). Several outcomes exhibited moderate-to-high heterogeneity. Collectively, these findings suggest that EUC mitigates estrogen-deficiency–associated bone loss in preclinical PMOP models by preserving bone mass, structure and strength, plausibly through coordinated effects on bone resorption and formation. As a botanical derivative, EUC may hold promise as a dietary supplement or adjunctive approach for PMOP management; however, mechanistic studies and more standardized preclinical protocols are needed to strengthen translational relevance. Systematic Review Registration https://inplasy.com/inplasy-2022-11-0093/ , identifier [INPLASY2022110093].