Moreover, sulfated GAGs are known to inhibit the differentiation of osteoclasts, and the sulfation level of OMD is higher during the ECM mineralization process.47,48 Our findings present OMD as a novel regulator of the bone remodeling process that is able to protect against subchondral bone sclerosis in pathological conditions such as OA. This evidence concerns the gene OMD and occult macular dystrophy.