PATHOLOGY

Detailed explanation-1: -Bone contains several growth factors, including bone morphogenetic proteins (BMPs), transforming growth factor beta (TGF-), insulin-like growth factors I and II (IGF-I and IGF-II), platelet derived growth factor (PDGF) and basic and acidic fibroblast growth factor (bFGF and aFGF).

Detailed explanation-2: -It is reached when the growth in the size of bones and accumulation of bone mineral has stabilized (consolidation). Determinants of peak bone mass include hereditary factors, sex and race (70-80%), and lifestyle factors such as calcium, vitamin D, exercise, smoking, use of steroids, etc. (20-30%).

Detailed explanation-3: -Insulin has an anabolic effect on bone [22, 23], through the stimulation of osteoblast differentiation, which enhances production of osteocalcin [24].

Detailed explanation-4: -Most agree that endogenous insulin has an anabolic effect on bone [18–22]. However, there are several mechanisms by which diabetes can affect bone health. These include hyperglycemia, hyperinsulinemia and insulin-like growth factor-1 (IGF-1), antidiabetic agents, and diabetes disease severity to name a few [19–36].