An increase in the number of osteoblasts also increases the amount of Osterix, and decreases the amount of RANKL, the ratio of RANKL/OPG, and the expression of cathepsin K. Furthermore, high amount of osteoblasts suppresses the production of TNF, which acts in the process of resorption and osteoclastogenesis.40 In patients with type 2 diabetes mellitus, the volume and thickness of the osteoid, the amount of osteoblasts, and Alkaline Phosphatase (ALP) decrease. Here, CTSK is linked to type 2 diabetes mellitus.