Long-term use of Probiotics and Bone Mineral Density (BMD), Bone Turnover Markers (BTMs) and Fracture Risk among Postmenopausal Women: A Scoping Review

Abstract

Background: Bone mineral density (BMD), bone turnover markers (BTMs) and fracture risk are key indicators of bone health, particularly in postmenopausal women who are at increased risk of osteoporosis. Probiotic supplementation has emerged as a potential intervention to improve bone health by modulating gut microbiota and systemic inflammation.

Objectives: To identify and describe the types of studies conducted on BMD, BTMs, fracture risk and probiotic supplementation in postmenopausal women.

Aim: This review explicitly examines and synthesises available evidence regarding the relationship between BMD, BTMs and fracture risk in postmenopausal women, the impact of probiotic supplementation on these parameters, and the characteristics of populations studied, research concepts, and study contexts.

Eligibility criteria: Original research studies investigating the effects of probiotic supplementation on BMD, BTMs and fracture risk in postmenopausal women, with clear reporting of outcomes and relevant intervention details.

Sources of evidence: Comprehensive database searches, complemented by manual screening, were used to identify studies that met the inclusion criteria.

Charting methods: A narrative synthesis approach was used to collate and analyse study characteristics and findings, with attention to heterogeneity in interventions, eligibility criteria, outcome measurement sites, and co-supplementation regimens.

Results: Five studies met the inclusion criteria. Three of these showed significant positive effects of probiotic supplementation on BMD, predominantly in trabecular-rich regions of bones. The included studies were highly heterogeneous regarding co-interventions, eligibility criteria, anatomical sites used for primary outcomes, co-supplementation strategies and findings in BTMs and fracture risk.

Conclusions: Despite substantial heterogeneity, probiotic supplementation shows promise in improving bone health in postmenopausal women, particularly in trabecular bone regions. The review provides a comprehensive synthesis of current evidence and highlights the need for more standardised, rigorous long-term research to confirm these preliminary findings.