Aging biomarkers and osteoporosis: a systematic review of epigenetic clocks and telomere length
This systematic review of human epidemiological studies found inconclusive population-level evidence on whether blood-based epigenetic aging clocks or leukocyte telomere length are associated with osteoporosis-related outcomes, while laboratory-based studies often did show associations. [1]
Automatic summary · not editorially reviewed
The key findings
The review aimed to summarize associations between DNA methylation and telomere dysfunction, mainly telomere shortening, and bone health. [1]
Five epigenetic aging-related studies and 14 telomere-length-related studies were included. [1]
Population-level epidemiological studies gave inconclusive evidence, with limited clock studies and inconsistent telomere-length findings. [1]
The source at a glance
- Study type / format
- Systematic review of human epidemiological studies (abstract)
- Population / context
- Human epidemiological studies of blood-based epigenetic aging clocks or leukocyte telomere length and osteoporosis-related outcomes
- Summary based on
- Study abstract
- Original publication
- June 2, 2026
Review question on biological aging and bone health
The review notes that chronological age is an important risk factor for osteoporosis, but biological aging measures may better capture differences in systemic and bone-tissue aging among people of the same age. It aimed to summarize associations between DNA methylation and telomere dysfunction (mainly telomere shortening) and bone health. The authors searched PubMed and Embase for human epidemiological studies linking blood-based epigenetic aging clocks or leukocyte telomere length to osteoporosis-related outcomes.
Supporting source [1]
Five clock studies and 14 telomere studies included
Five epigenetic aging-related studies and 14 telomere-length-related studies were included. Data on study design, population, bone health-related outcomes and statistically significant effect estimates were extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale for observational studies. Because study designs, biomarkers and outcome definitions differed, findings were summarized narratively rather than pooled. The review concludes that laboratory-based studies often provide evidence of an association between aging biomarkers and bone outcomes, whereas population-level epidemiological studies give inconclusive evidence.
Supporting source [1]
Small samples and inconsistent telomere findings
The review reports limited studies on epigenetic aging clocks and bone health and inconsistent findings on the association between leukocyte telomere length and bone health. Challenges in many of the human studies included small sample sizes, inadequate study designs, non-diverse cohorts, and heterogeneity in epigenetic clock selection and/or bone health outcomes. The authors call for prospective studies with larger, independent cohorts and comprehensive adjustment for intervening factors. This summary is based on the abstract only; the full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. The review summarized heterogeneous observational studies narratively, so no pooled estimate is reported here.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Liu M, Jung SY. · europepmc.org · June 2, 2026