Osteoblasts in high glucose concentrations cause less pro-osteogenic markers such as Runx2 and Osx.41 Moreover, apoptosis of osteoblasts and their precursor cells increased.39 Type 2 diabetes mellitus also increases the negative effect on osteoblasts by directing the differentiation of MSCs into adipose, leading to low osteoblast function, formation, and bone mass.42 Here, SP7 is linked to diabetes mellitus.