It is of note that BMSi was also found to be inversely correlated with markers of underlying disease activity in secondary osteoporosis such as AGE accumulation in type 2 diabetes mellitus (49), and serum chitotriosidase levels in type 1 Gaucher Disease (57), suggesting that material properties of bone are more severely altered the more severely uncontrolled the disease is. Here, CHIT1 is linked to osteoporosis.