Osteoporosis, a metabolic bone disease characterized by low bone mineral density and deterioration of bone microarchitecture, has led to a high risk of fatal osteoporotic fractures worldwide. Accumulating evidence has revealed that sexual dimorphism is a notable feature of osteoporosis, with sex-specific differences in epidemiology and pathogenesis. Specifically, females are more susceptible than males to osteoporosis, while males are more prone to disability or death from the disease. To date, sex chromosome abnormalities and steroid hormones have been proven to contribute greatly to sexual dimorphism in osteoporosis by regulating the functions of bone cells. Understanding the sex-specific differences in osteoporosis and its related complications is essential for improving treatment strategies tailored to women and men. This literature review focuses on the mechanisms underlying sexual dimorphism in osteoporosis, mainly in a population of aging patients, chronic glucocorticoid administration, and diabetes. Moreover, we highlight the implications of sexual dimorphism for developing therapeutics and preventive strategies and screening approaches tailored to women and men. Additionally, the challenges in translating bench research to bedside treatments and future directions to overcome these obstacles will be discussed.

骨质疏松症是一种以骨矿物质密度低和骨微结构恶化为特征的代谢性骨病，导致全世界致命性骨质疏松性骨折的高风险。越来越多的证据表明，性别二态性是骨质疏松症的一个显着特征，在流行病学和发病机制上存在性别特异性差异。具体而言，女性比男性更容易患骨质疏松症，而男性则更容易因该疾病而致残或死亡。迄今为止，性染色体异常和类固醇激素已被证明通过调节骨细胞的功能对骨质疏松症的性别二态性产生很大影响。了解骨质疏松症及其相关并发症的性别差异对于改善针对女性和男性的治疗策略至关重要。本文献综述重点关注骨质疏松症中性别二态性的机制，主要发生在老年患者、长期服用糖皮质激素和糖尿病人群中。此外，我们强调了性别二态性对于制定针对女性和男性的治疗和预防策略以及筛查方法的影响。此外，还将讨论将实验室研究转化为临床治疗的挑战以及克服这些障碍的未来方向。