Inadequate insulin signalling can influence bone remodelling by reducing bone formation and increasing bone resorption.[5] Mechanisms being investigated are decreased osteoprotegerin (OPG) expression, an inhibitor of a member of the tumour necrosis factor family (RANKL) involved in bone resorption, and insulin receptor expression in osteoclasts impacting their recruitment.[5] However, the precise mechanism is still not fully understood, and the clinical significance is unclear, which makes further research on the link between PCOS, osteoporosis and insulin necessary. Here, TNFSF11 is linked to osteoporosis.