Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Longer life expectancy and increased obesity contribute to an increasing incidence of diabetes mellitus and osteoporosis. Recent meta-analyses and cohort studies confirm that diabetes is associated with higher fracture risk. Patients with type 2 diabetes display an increased fracture risk despite a higher bone mass, which is mainly attributable to non-skeletal risk factors. Patients with type 1 diabetes may have impaired bone formation because of the absence of the anabolic effects of insulin and IGF-1 system. Several clinical studies have reported adverse skeletal actions of PPARγ agonist in humans. Obesity regulates bone metabolism not only by increasing weight loading but by modulating adipokines which are known to affect bone remodeling. [Korean Journal of Bone Metabolism, 15(2): 91-98, 2008]
