Chronic GC exposure in Cushing's syndrome leads to a decreased function of osteoblasts, with a shift in the differentiation of bone marrow stromal cells away from osteoblasts and toward the adipocyte lineage in the bone.24, 25, 26 Consequently, Cushing's syndrome patients have decreased levels of circulating osteocalcin, an osteoblast‐derived factor.27 Concurrently, chronic GC exposure increases bone‐resorbing osteoclast survival.28, 29 Osteoblast and osteoclast markers are usually positively correlated because osteoblasts secrete important factors required for osteoclasts to function. Here, BGLAP is linked to Cushing syndrome due to macronodular adrenal hyperplasia.