Objective: Increased risk of osteoporosis in patients with diabetes is confirmed. However, earlier biomark-er as a diagnostic tool for diabetic osteopenia and osteoporosis is absent on clinical diagnosis. Osteoinductive factor (OIF) is known to be an essential component of the bone matrix. We aimed to investigate the relationship between OIF and 2 diabetes mellitus in combination with osteopenia or osteoporosis, and discussed the availability of the serological markers for diabetic osteopenia

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... osteoporosis screening. Methods: One hundred and twenty subjects were divided into four groups, including healthy controls group (Control, n = 30), patients with type 2 diabetes mel-litus group (DM, n = 30), type 2 diabetes mellitus with osteopenia (DOA, n = 42) and type 2 diabetes mellitus with osteoporosis (DOP, n = 18). Serum OIF levels were examined by ELISA, and other clinical biochemical parameters were tested based on standard methods. Results: OIF concentration in diabetic osteopenia and osteoporotic patients was significantly increased as compared to diabetic patients and healthy controls. Serum OIF was strongly correlated for urine calcium in diabetic osteopenia (r = 0.517, P = 0.0005) and osteoporosis patients (r = 0.779, P < 0.0001). Moreover, we observed a significant and negative correlation between serum OIF and T-score in osteope-nia and osteoporosis patients. Furthermore, the ROC curves illustrated strong separation between the control group and diabetic osteopenia group, with an AUC of 0.793 (95% CI: 0.668-0.919; P < 0.001) for OIF. Moreover, the ROC curves indicated that there was strong separation between the control group and diabetic osteoporosis group, with an AUC of 0.878 (95% CI: 0.776-0.977; P < 0.001) for OIF. Conclusions: OIF provided the highly diagnostic power for the detection of diabetic osteopenia or osteoporosis, suggesting that serum OIF could serve as a promising marker for diabetic osteopenia or osteoporosis diagnosis.