Importantly, a recent systemic review summarized that the preserved or even increased BMD as well as bone fragility with consequent increased susceptibility to fracture is common in T2DM patients compared to that of control, in which multiple regulatory mechanisms including microvascular disease, advanced glycation end products, osteoprotegerin/receptor-activator of nuclear factor κB ligand, the Wnt/β-catenin pathway, osteonectin, and fibroblast growth factor 23 are likely involved (14). Here, SPARC is linked to type 2 diabetes mellitus.