Skeletal defects in HPP, include rickets, osteomalacia, fractures, bone pain, and various dental defects.33,34 To understand the physiological role of ALPL and evaluate the potential treatments, several lines of ALPL knockout mice were generated.35,36 Homozygous mice show severe bone disease, but they often die before puberty.37 However, here, we found that ALPL deficiency in BMSCs caused decreased osteogenic differentiation and increased adipogenic differentiation. This evidence concerns the gene ALPL and osteomalacia.