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Abstract: Stauntonia hexaphylla (Thunb.) Decne (SH) is known for its anti-inflammatory,
analgesic, antioxidant, and anti-osteoporotic properties. This study investigated the composition
of SH leaves and fruits and assessed their individual and combined effects in
an in vitro osteoporosis model. Extracts with varying leaf-to-fruit ratios (SH82, SH55,
SH28) were evaluated in MC3T3-E1 and RAW264.7 cells to examine osteogenesis and bone
resorption biomarkers. SH leaves were rich in chlorogenic acids (CGAs) and flavonoids,
while fruits contained phenolic acids with minimal flavonoids. Leaf extracts exhibited
superior antioxidant activity and ROS suppression. Both leaf and fruit extracts enhanced
ALP activity, calcium deposition, and collagen formation in MC3T3-E1 cells, with leaf extracts
demonstrating greater efficacy. Additionally, osteoblastogenesis-related genes were
upregulated, while TRAP activity and osteoclast-related gene expression were significantly
inhibited. The combined extract exerted a synergistic effect, with SH28 showing the most
pronounced osteogenic enhancement and TRAP inhibition. Key components, including
neo-CGA, CGA, rutin, and luteolin-7-O-glucoside, positively influenced ALP and TRAP
activities. These findings highlight the potential of SH, particularly at a high leaf-to-fruit
ratio, as a promising natural agent for osteoporosis prevention.