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In recent years, accumulating evidence has shown that systemic inflammatory responses in IBD exert detrimental effects on bone metabolism, primarily through the release of pro-inflammatory cytokines that disrupt the balance between bone resorption and bone formation ( 3.1 Inflammation-mediated alterations in bone metabolism In patients with IBD, chronic intestinal inflammation activates immune cells and induces the release of pro-inflammatory cytokines—such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)—which directly promote osteoclastogenesis and accelerate bone resorption, ultimately leading to reduced BMD ( 3.2 Gut microbiota and bone metabolism The contribution of the GM to bone metabolism has attracted growing interest