ICA reshapes bone tissue energy metabolism homeostasis through precise modulation of estrogen signaling (Yao et al., 2025), gut microbiota (Zhang Y. et al., 2021), OCN (Mohammadi et al., 2024), and ALP (Omidvar et al., 2022), providing a targeted therapeutic strategy for metabolic disorder-associated osteoporosis (Xie et al., 2023; Zhang et al., 2011; Zhang et al., 2008). The gene discussed is BGLAP; the disease is metabolic disease.