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Müller TD, Adriaenssens A, Ahrén B, Blüher M, Birkenfeld AL, Campbell JE, Coghlan MP, D'Alessio D, Deacon CF, DelPrato S, Douros JD, Drucker DJ, Figueredo Burgos NS, Flatt PR, Finan B, Gimeno RE, Gribble FM, Hayes MR, Hölscher C, Holst JJ, Knerr PJ, Knop FK, Kusminski CM, Liskiewicz A, Mabilleau G, Mowery SA, Nauck MA, Novikoff A, Reimann F, Roberts AG, Rosenkilde MM, Samms RJ, Scherer PE, Seeley RJ, Sloop KW, Wolfrum C, Wootten D, DiMarchi RD, Tschöp MH. Glucose-dependent insulinotropic polypeptide (GIP). Mol Metab 2025; 95:102118. [PMID: 40024571 PMCID: PMC11931254 DOI: 10.1016/j.molmet.2025.102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Revised: 02/06/2025] [Accepted: 02/24/2025] [Indexed: 03/04/2025] Open
Abstract
BACKGROUND Glucose-dependent insulinotropic polypeptide (GIP) was the first incretin identified and plays an essential role in the maintenance of glucose tolerance in healthy humans. Until recently GIP had not been developed as a therapeutic and thus has been overshadowed by the other incretin, glucagon-like peptide 1 (GLP-1), which is the basis for several successful drugs to treat diabetes and obesity. However, there has been a rekindling of interest in GIP biology in recent years, in great part due to pharmacology demonstrating that both GIPR agonism and antagonism may be beneficial in treating obesity and diabetes. This apparent paradox has reinvigorated the field, led to new lines of investigation, and deeper understanding of GIP. SCOPE OF REVIEW In this review, we provide a detailed overview on the multifaceted nature of GIP biology and discuss the therapeutic implications of GIPR signal modification on various diseases. MAJOR CONCLUSIONS Following its classification as an incretin hormone, GIP has emerged as a pleiotropic hormone with a variety of metabolic effects outside the endocrine pancreas. The numerous beneficial effects of GIPR signal modification render the peptide an interesting candidate for the development of pharmacotherapies to treat obesity, diabetes, drug-induced nausea and both bone and neurodegenerative disorders.
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Affiliation(s)
- Timo D Müller
- Institute for Diabetes and Obesity, Helmholtz Munich, Germany; German Center for Diabetes Research, DZD, Germany; Walther-Straub Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University Munich (LMU), Germany.
| | - Alice Adriaenssens
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology, and Pharmacology, University College London, London, UK
| | - Bo Ahrén
- Department of Clinical Sciences, Lund, Lund University, Lund, Sweden
| | - Matthias Blüher
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany; Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Andreas L Birkenfeld
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen 72076, Germany; Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Jonathan E Campbell
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA; Department of Medicine, Division of Endocrinology, Duke University, Durham, NC, USA; Department of Pharmacology and Cancer Biology, Duke University, Durham, NC, USA
| | - Matthew P Coghlan
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - David D'Alessio
- Department of Medicine, Division of Endocrinology, Duke University, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
| | - Carolyn F Deacon
- School of Biomedical Sciences, Ulster University, Coleraine, UK; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stefano DelPrato
- Interdisciplinary Research Center "Health Science", Sant'Anna School of Advanced Studies, Pisa, Italy
| | | | - Daniel J Drucker
- The Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natalie S Figueredo Burgos
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology, and Pharmacology, University College London, London, UK
| | - Peter R Flatt
- Diabetes Research Centre, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland BT52 1SA, UK
| | - Brian Finan
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Ruth E Gimeno
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Fiona M Gribble
- Institute of Metabolic Science-Metabolic Research Laboratories & MRC-Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - Matthew R Hayes
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christian Hölscher
- Neurodegeneration Research Group, Henan Academy of Innovations in Medical Science, Xinzheng, China
| | - Jens J Holst
- Department of Biomedical Sciences and the Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Patrick J Knerr
- Indianapolis Biosciences Research Institute, Indianapolis, IN, USA
| | - Filip K Knop
- Center for Clinical Metabolic Research, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Kusminski
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Arkadiusz Liskiewicz
- Institute for Diabetes and Obesity, Helmholtz Munich, Germany; German Center for Diabetes Research, DZD, Germany; Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Guillaume Mabilleau
- Univ Angers, Nantes Université, ONIRIS, Inserm, RMeS UMR 1229, Angers, France; CHU Angers, Departement de Pathologie Cellulaire et Tissulaire, Angers, France
| | | | - Michael A Nauck
- Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Aaron Novikoff
- Institute for Diabetes and Obesity, Helmholtz Munich, Germany; German Center for Diabetes Research, DZD, Germany
| | - Frank Reimann
- Institute of Metabolic Science-Metabolic Research Laboratories & MRC-Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - Anna G Roberts
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology, and Pharmacology, University College London, London, UK
| | - Mette M Rosenkilde
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Ricardo J Samms
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Philip E Scherer
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Randy J Seeley
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Kyle W Sloop
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - Christian Wolfrum
- Institute of Food, Nutrition and Health, ETH Zurich, 8092, Schwerzenbach, Switzerland
| | - Denise Wootten
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; ARC Centre for Cryo-electron Microscopy of Membrane Proteins, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | | | - Matthias H Tschöp
- Helmholtz Munich, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technical University of Munich, Munich, Germany
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Kupai K, Kang HL, Pósa A, Csonka Á, Várkonyi T, Valkusz Z. Bone Loss in Diabetes Mellitus: Diaporosis. Int J Mol Sci 2024; 25:7269. [PMID: 39000376 PMCID: PMC11242219 DOI: 10.3390/ijms25137269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/21/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
The objective of this review is to examine the connection between osteoporosis and diabetes, compare the underlying causes of osteoporosis in various forms of diabetes, and suggest optimal methods for diagnosing and assessing fracture risk in diabetic patients. This narrative review discusses the key factors contributing to the heightened risk of fractures in individuals with diabetes, as well as the shared elements impacting the treatment of both diabetes mellitus and osteoporosis. Understanding the close link between diabetes and a heightened risk of fractures is crucial in effectively managing both conditions. There are several review articles of meta-analysis regarding diaporosis. Nevertheless, no review articles showed collected and well-organized medications of antidiabetics and made for inconvenient reading for those who were interested in details of drug mechanisms. In this article, we presented collected and comprehensive charts of every antidiabetic medication which was linked to fracture risk and indicated plausible descriptions according to research articles.
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Affiliation(s)
- Krisztina Kupai
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Hsu Lin Kang
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Anikó Pósa
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Ákos Csonka
- Department of Traumatology, University of Szeged, 6725 Szeged, Hungary;
| | - Tamás Várkonyi
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
| | - Zsuzsanna Valkusz
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
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Emanuelsson F, Afzal S, Jørgensen NR, Nordestgaard BG, Benn M. Hyperglycaemia, diabetes and risk of fragility fractures: observational and Mendelian randomisation studies. Diabetologia 2024; 67:301-311. [PMID: 38095658 PMCID: PMC10789835 DOI: 10.1007/s00125-023-06054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/12/2023] [Indexed: 01/16/2024]
Abstract
AIMS/HYPOTHESIS Fragility fractures may be a complication of diabetes, partly caused by chronic hyperglycaemia. We hypothesised that: (1) individuals with hyperglycaemia and diabetes have increased risk of fragility fracture; (2) hyperglycaemia is causally associated with increased risk of fragility fracture; and (3) diabetes and fragility fracture jointly associate with the highest risk of all-cause mortality. METHODS In total, 117,054 individuals from the Copenhagen City Heart Study and the Copenhagen General Population Study (the Copenhagen studies) and 390,374 individuals from UK Biobank were included for observational and one-sample Mendelian randomisation (MR) analyses. Fragility fractures were defined as fractures at the hip, spine and arm (humerus/wrist), collected from national health registries. Summary data for fasting glucose and HbA1c concentrations from 196,743 individuals in the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) were combined with data on fragility fractures from the Copenhagen studies in two-sample MR analyses. RESULTS Higher fasting and non-fasting glucose and HbA1c concentrations were associated with higher risk of any fragility fracture (p<0.001). Individuals with vs without diabetes had HRs for fragility fracture of 1.50 (95% CI 1.19, 1.88) in type 1 diabetes and 1.22 (1.13, 1.32) in type 2 diabetes. One-sample MR supported a causal association between high non-fasting glucose concentrations and increased risk of arm fracture in the Copenhagen studies and UK Biobank combined (RR 1.41 [1.11, 1.79], p=0.004), with similar results for fasting glucose and HbA1c in two-sample MR analyses (ORs 1.50 [1.03, 2.18], p=0.03; and 2.79 [1.12, 6.93], p=0.03, respectively). The corresponding MR estimates for any fragility fracture were 1.18 (1.00, 1.41), p=0.06; 1.36 (0.89, 2.09), p=0.15; and 2.47 (0.95, 6.43), p=0.06, respectively. At age 80 years, cumulative death was 27% in individuals with fragility fracture only, 54% in those with diabetes only, 67% in individuals with both conditions and 17% in those with neither. CONCLUSIONS/INTERPRETATION Hyperglycaemia and diabetes are risk factors for fragility fracture and one- and two-sample MR analyses supported a causal effect of hyperglycaemia on arm fractures. Diabetes and previous fragility fracture jointly conferred the highest risk of death in the general population.
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Affiliation(s)
- Frida Emanuelsson
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Centre of Diagnostic Investigation, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shoaib Afzal
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Niklas R Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Centre of Diagnostic Investigation, Glostrup, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Centre of Diagnostic Investigation, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- The Copenhagen General Population Study, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark.
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Hartmann B, Longo M, Mathiesen DS, Hare KJ, Jørgensen NR, Esposito K, Deacon CF, Vilsbøll T, Holst JJ, Knop FK. Signs of a Glucose- and Insulin-Independent Gut-Bone Axis and Aberrant Bone Homeostasis in Type 1 Diabetes. J Clin Endocrinol Metab 2023; 109:e259-e265. [PMID: 37466204 DOI: 10.1210/clinem/dgad431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/15/2023] [Accepted: 07/17/2023] [Indexed: 07/20/2023]
Abstract
CONTEXT Gut hormones seem to play an important role in postprandial bone turnover, which also may be affected by postprandial plasma glucose excursions and insulin secretion. OBJECTIVE To investigate the effect of an oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI) on bone resorption and formation markers in individuals with type 1 diabetes and healthy controls. METHODS This observational case-control study, conducted at the Center for Clinical Metabolic Research, Gentofte Hospital, Hellerup, Denmark, included 9 individuals with C-peptide negative type 1 diabetes and 8 healthy controls matched for gender, age, and body mass index. Subjects underwent an OGTT and a subsequent IIGI. We analyzed changes in bone resorption assessed by measurements of carboxy-terminal type I collagen crosslinks (CTX) and in bone formation as assessed by procollagen type I N-terminal propeptide (PINP) concentrations. RESULTS Baseline CTX and PINP levels were similar in the 2 groups. Both groups exhibited significantly greater suppression of CTX during OGTT than IIGI. PINP levels were unaffected by OGTT and IIGI, respectively, in healthy controls. Participants with type 1 diabetes displayed impaired suppression of CTX-assessed bone resorption and inappropriate suppression of PINP-assessed bone formation during OGTT. CONCLUSION Our data suggest the existence of a gut-bone axis reducing bone resorption in response to oral glucose independently of plasma glucose excursions and insulin secretion. Subjects with type 1 diabetes showed impaired suppression of bone resorption and reduced bone formation during OGTT, which may allude to the reduced bone mineral density and increased fracture risk characterizing these individuals.
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Affiliation(s)
- Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Miriam Longo
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - David S Mathiesen
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark
| | - Kristine J Hare
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Niklas R Jørgensen
- Department of Clinical Biochemistry, Centre of Diagnostic Investigation, Rigshospitalet, University of Copenhagen, DK-2100 Glostrup, Denmark
- Clinical Research, Steno Diabetes Center Copenhagen, DK-2750 Herlev, Denmark
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Carolyn F Deacon
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Tina Vilsbøll
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
- Clinical Research, Steno Diabetes Center Copenhagen, DK-2750 Herlev, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Filip K Knop
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
- Clinical Research, Steno Diabetes Center Copenhagen, DK-2750 Herlev, Denmark
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Fuller KN, Bohne EM, Mey JT, Blackburn BK, Miranda VR, Varady KA, Danielson KK, Haus JM. Plasma undercarboxylated osteocalcin dynamics with glycemic stress reflects insulin sensitivity and beta-cell function in humans with and without T2DM. Metabol Open 2023; 20:100264. [PMID: 38115864 PMCID: PMC10728569 DOI: 10.1016/j.metop.2023.100264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
This study aimed to better understand the relationship between bone-related biomarkers and nutrient stress in the context of metabolic health. We investigated plasma osteocalcin (OC) during an oral glucose challenge and experimental hyperinsulinemia in Type 2 diabetes (T2DM) and lean healthy controls (LHC). Older individuals with obesity and T2DM (n = 9) and young LHCs (n = 9) underwent a 75g oral glucose tolerance test (OGTT) and a 40 mU/m2/min hyperinsulinemic-euglycemic clamp. Plasma undercarboxylated OC (ucOC) and total OC were measured at baseline, 60mins, and 120mins of the OGTT and clamp via ELISA. In addition, plasma alkaline phosphatase (ALP), leptin, adiponectin, Vitamin D and insulin were measured and indices of insulin sensitivity and β-cell function were derived. The T2DM group had lower (p<0.05) ucOC and ucOC:total OC ratio than LHC during both the OGTT and clamp. Further, baseline ucOC was positively correlated to indices of β-cell function and negatively correlated to indices of insulin resistance when both groups were combined (all p<0.05). Suppression of OC observed in T2DM may be related to glucose intolerance and insulin resistance. Similarly, our data suggest that the observed phenotypic differences between groups are likely a product of long-term glucose dysregulation rather than acute flux in glucose or insulin.
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Affiliation(s)
- Kelly N.Z. Fuller
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Erin M. Bohne
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, IL, USA
| | - Jacob T. Mey
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Brian K. Blackburn
- Applied Health Sciences and Kinesiology, Humboldt State University, Arcata, CA, USA
| | | | - Krista A. Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, IL, USA
| | - Kirstie K. Danielson
- Division of Endocrinology and Metabolism, University of Illinois at Chicago, IL, USA
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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Sheu A, Blank RD, Tran T, Bliuc D, Greenfield JR, White CP, Center JR. Associations of Type 2 Diabetes, Body Composition, and Insulin Resistance with Bone Parameters: The Dubbo Osteoporosis Epidemiology Study. JBMR Plus 2023; 7:e10780. [PMID: 37701154 PMCID: PMC10494511 DOI: 10.1002/jbm4.10780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 09/14/2023] Open
Abstract
Type 2 diabetes (T2D) may be associated with increased risk of fractures, despite preserved bone mineral density (BMD). Obesity and insulin resistance (IR) may have separate effects on bone turnover and bone strength, which contribute to skeletal fragility. We characterized and assessed the relative associations of obesity, body composition, IR, and T2D on bone turnover markers (BTMs), BMD, and advanced hip analysis (AHA). In this cross-sectional analysis of Dubbo Osteoporosis Epidemiology Study, 525 (61.3% women) participants were grouped according to T2D, IR (homeostasis model assessment insulin resistance [HOMA-IR] ≥2.5), and BMI (≥25 kg/m2): insulin-sensitive lean (IS-L), insulin-sensitive overweight/obese (IS-O), insulin-resistant (IR), and T2D. BMD, AHA, and body composition, including visceral adipose tissue (VAT) (on dual-energy x-ray absorptiometry scan) and fasting BTMs, were assessed. Analyses performed using Bayesian model averaging and principal component analysis. T2D was associated with low BTMs (by 26%-30% [95% confidence interval [CI] 11%-46%] in women, 35% [95% CI 18%-48%] in men compared to IS-L), which persisted after adjustment for VAT. BTMs were similar among IR/IS-O/IS-L. BMD was similar among T2D/IR/IS-O; BMD was low only in IS-L. All groups were similar after adjustment for BMI. Similarly, AHA components were lowest in IS-L (attenuated following adjustment). On multivariate analysis, T2D was independently associated with BTMs. IR was also associated with C-terminal telopeptide of type 1 collagen in men. Age and body size were the strongest independent contributors to BMD and AHA. VAT was inversely associated with section modulus, cross-sectional area, cross-sectional moment of inertia in women, and hip axis length in men. Low bone turnover is associated with T2D and IR (in men), while BMD and hip strength/geometry are predominantly associated with body size. VAT, indicative of dysglycemia, is also associated with impaired bone geometry. Establishing the role of BTMs and AHA fracture risk may improve skeletal assessment in T2D people. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Angela Sheu
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
- Department of Endocrinology and DiabetesSt Vincent's HospitalSydneyNSWAustralia
| | - Robert D. Blank
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
| | - Thach Tran
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
| | - Dana Bliuc
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
| | - Jerry R. Greenfield
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
- Department of Endocrinology and DiabetesSt Vincent's HospitalSydneyNSWAustralia
| | - Christopher P. White
- School of Clinical Medicine, Prince of Wales Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
- Department of Endocrinology and MetabolismPrince of Wales HospitalSydneyNSWAustralia
| | - Jacqueline R. Center
- Skeletal Diseases ProgramGarvan Institute of Medical ResearchSydneyNSWAustralia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Faculty of Medicine and HealthUNSW SydneySydneyNSWAustralia
- Department of Endocrinology and DiabetesSt Vincent's HospitalSydneyNSWAustralia
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One week of high-fat overfeeding alters bone metabolism in healthy males: A pilot study. Nutrition 2022; 96:111589. [DOI: 10.1016/j.nut.2022.111589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/11/2021] [Accepted: 12/29/2021] [Indexed: 11/19/2022]
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Sharma DK, Anderson PH, Morris HA, Clifton PM. Acute CTX-1 Suppression With Milk Calcium or Calcium Carbonate is Independent of Visceral Fat in A Randomized Crossover Study in Lean and Overweight Postmenopausal Women. J Nutr 2021; 152:1006-1014. [PMID: 36967157 DOI: 10.1093/jn/nxab384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/24/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Postmenopausal women with higher visceral adipose tissue (VAT) present with suppressed bone resorption (lower c-terminal cross-linking telopeptide of type I collagen, CTX-1) and turnover (lower osteocalcin) but whether this blunts the effect of calcium is unknown. OBJECTIVE The primary outcome of this study was the effect of VAT on changes in CTX-1 after intake of two forms of calcium. Secondary outcomes included changes in parathyroid hormone (PTH), serum calcium, phosphorus, and alkaline phosphatase (ALP). DESIGN Randomized open three period crossover trial conducted between 2017-2019 at the University of South Australia among 77 lean and overweight postmenopausal women (53-79 y) with body mass index (BMI) less than 25 kg/m2 and greater than 27 kg/m2, respectively. Participants received a single dose of milk (1000 mg calcium), calcium carbonate tablet (1000 mg calcium), and fruit juice (no calcium) in random order with a seven-day washout period. Blood samples were collected at baseline and hourly for 5h. Data was analysed by repeated measures analysis of variance (ANOVA) of log-transformed data. RESULTS At baseline, women with higher VAT had significantly lower CTX-1 and higher PTH (44% lower and 30% higher, respectively between Q4 and Q1, P < 0.0001). VAT had no influence on the acute changes in CTX-1 or PTH with calcium or juice. A suppression of 44% in CTX-1 was seen with calcium carbonate and milk and a suppression of 18% with juice. PTH was suppressed more with calcium carbonate (47%) compared to milk (22%). Milk calcium reduced PTH and CTX-1 at 2-hour while calcium carbonate reduced PTH in 1 hour. The suppression in CTX-1 was slower with lowest levels at 4-5 hour. CONCLUSIONS 1000 mg calcium obtained from milk or from calcium carbonate is effective in acutely suppressing bone resorption in postmenopausal women irrespective of visceral fat.This trial is registered with the Australian New Zealand Clinical Trials Registry http://www.ANZCTR.org.au/ACTRN12617000779370.aspx (ACTRN 12617000779370).
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Affiliation(s)
- Deepti K Sharma
- Clinical and Health Sciences Academic Unit, University of South Australia, Adelaide, Australia.,Department of Orthopaedics and Trauma, Royal Adelaide Hospital
| | - Paul H Anderson
- Clinical and Health Sciences Academic Unit, University of South Australia, Adelaide, Australia
| | - Howard A Morris
- Clinical and Health Sciences Academic Unit, University of South Australia, Adelaide, Australia
| | - Peter M Clifton
- Clinical and Health Sciences Academic Unit, University of South Australia, Adelaide, Australia
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9
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Winter EM, Kooijman S, Appelman-Dijkstra NM, Meijer OC, Rensen PC, Schilperoort M. Chronobiology and Chronotherapy of Osteoporosis. JBMR Plus 2021; 5:e10504. [PMID: 34693186 PMCID: PMC8520066 DOI: 10.1002/jbm4.10504] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/31/2021] [Accepted: 04/10/2021] [Indexed: 12/31/2022] Open
Abstract
Physiological circadian (ie, 24-hour) rhythms are critical for bone health. Animal studies have shown that genes involved in the intrinsic molecular clock demonstrate potent circadian expression patterns in bone and that genetic disruption of these clock genes results in a disturbed bone structure and quality. More importantly, circulating markers of bone remodeling show diurnal variation in mice as well as humans, and circadian disruption by, eg, working night shifts is associated with the bone remodeling disorder osteoporosis. In this review, we provide an overview of the current literature on rhythmic bone remodeling and its underlying mechanisms and identify critical knowledge gaps. In addition, we discuss novel (chrono)therapeutic strategies to reduce osteoporosis by utilizing our knowledge on circadian regulation of bone. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Elizabeth M Winter
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands.,Department of Medicine, Center for Bone Quality Leiden University Medical Center Leiden The Netherlands
| | - Sander Kooijman
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Natasha M Appelman-Dijkstra
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands.,Department of Medicine, Center for Bone Quality Leiden University Medical Center Leiden The Netherlands
| | - Onno C Meijer
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Patrick Cn Rensen
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Maaike Schilperoort
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
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10
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Dušková M, Kolátorová L, Jandíková H, Pospíšilová H, Stárka L. Are there sex differences in the reaction of undercarboxylated osteocalcin to hypoglycemia? Physiol Res 2021; 69:S315-S320. [PMID: 33094629 DOI: 10.33549/physiolres.934520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
There has been increasing evidence in recent years for the hypothesis of bones as endocrine organs. Osteocalcin, long considered just a marker of new bone formation, is now seen as the first hormone produced by bones, and seems to be associated with regulating glucose metabolism and reproduction. The aim of this work was to monitor changes of osteocalcin in reaction to hypoglycemia, and determine if there are differences in such reactions between the sexes. The study included 61 healthy probands with physiological calciophosphate metabolism (30 men and 31 women). We applied to each of them an insulin tolerance test, and then monitored levels of undercarboxylated osteocalcin and reactions to hypoglycemia at regular time intervals. We found differences in the reaction to hypoglycemia between the sexes. In men there was a significant decline in undercarboxylated osteocalcin between the 30 and 40 min (p<0.0015), which reflects a reaction to a glycemic decline between 25-30 min, followed by reversal. Low undercarboxylated osteocalcin in men lasted up to 90 min, after which they returned to levels before the test. In women we did not find any significant changes in undercarboxylated osteocalcin levels. Changes in undercarboxylated osteocalcin induced by hypoglycemia indicate a relationship between bones and glucose metabolism. There was an interesting difference between the sexes. However, a definitive conclusion about the role of osteocalcin in human metabolism will require numerous future studies.
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Affiliation(s)
- M Dušková
- Department of Steroids and Proteofactors, Institute of Endocrinology, Prague, Czech Republic.
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11
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Skov‐Jeppesen K, Hepp N, Oeke J, Hansen MS, Jafari A, Svane MS, Balenga N, Olson JA, Frost M, Kassem M, Madsbad S, Beck Jensen J, Holst JJ, Rosenkilde MM, Hartmann B. The Antiresorptive Effect of GIP, But Not GLP-2, Is Preserved in Patients With Hypoparathyroidism-A Randomized Crossover Study. J Bone Miner Res 2021; 36:1448-1458. [PMID: 33852173 PMCID: PMC8338760 DOI: 10.1002/jbmr.4308] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/17/2021] [Accepted: 04/08/2021] [Indexed: 01/20/2023]
Abstract
Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-2 (GLP-2) are gut hormones secreted postprandially. In healthy humans, both hormones decrease bone resorption accompanied by a rapid reduction in parathyroid hormone (PTH). The aim of this study was to investigate whether the changes in bone turnover after meal intake and after GIP- and GLP-2 injections, respectively, are mediated via a reduction in PTH secretion. This was tested in female patients with hypoparathyroidism given a standardized liquid mixed-meal test (n = 7) followed by a peptide injection test (n = 4) using a randomized crossover design. We observed that the meal- and GIP- but not the GLP-2-induced changes in bone turnover markers were preserved in the patients with hypoparathyroidism. To understand the underlying mechanisms, we examined the expression of the GIP receptor (GIPR) and the GLP-2 receptor (GLP-2R) in human osteoblasts and osteoclasts as well as in parathyroid tissue. The GIPR was expressed in both human osteoclasts and osteoblasts, whereas the GLP-2R was absent or only weakly expressed in osteoclasts. Furthermore, both GIPR and GLP-2R were expressed in parathyroid tissue. Our findings suggest that the GIP-induced effect on bone turnover may be mediated directly via GIPR expressed in osteoblasts and osteoclasts and that this may occur independent of PTH. In contrast, the effect of GLP-2 on bone turnover seems to depend on changes in PTH and may be mediated through GLP-2R in the parathyroid gland. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Kirsa Skov‐Jeppesen
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
- Novo Nordisk Foundation Center for Basic Metabolic ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Nicola Hepp
- Department of EndocrinologyHvidovre University HospitalHvidovreDenmark
| | - Jannika Oeke
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Morten Steen Hansen
- Molecular Endocrinology Unit (KMEB), Department of EndocrinologyOdense University HospitalOdenseDenmark
| | - Abbas Jafari
- Department of Cellular and Molecular Medicine, Novo Nordisk Foundation Center for Stem Cell Biology (Danstem)University of CopenhagenCopenhagenDenmark
| | - Maria Saur Svane
- Department of EndocrinologyHvidovre University HospitalHvidovreDenmark
| | - Nariman Balenga
- Division of General and Oncologic Surgery, Department of Surgery, Marlene and Stewart Greenebaum Comprehensive Cancer CenterUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - John A Olson
- Division of General and Oncologic Surgery, Department of Surgery, Marlene and Stewart Greenebaum Comprehensive Cancer CenterUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Morten Frost
- Molecular Endocrinology Unit (KMEB), Department of EndocrinologyOdense University HospitalOdenseDenmark
| | - Moustapha Kassem
- Molecular Endocrinology Unit (KMEB), Department of EndocrinologyOdense University HospitalOdenseDenmark
- Department of Cellular and Molecular Medicine, Novo Nordisk Foundation Center for Stem Cell Biology (Danstem)University of CopenhagenCopenhagenDenmark
| | - Sten Madsbad
- Department of EndocrinologyHvidovre University HospitalHvidovreDenmark
| | - Jens‐Erik Beck Jensen
- Department of EndocrinologyHvidovre University HospitalHvidovreDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jens Juul Holst
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
- Novo Nordisk Foundation Center for Basic Metabolic ResearchUniversity of CopenhagenCopenhagenDenmark
| | | | - Bolette Hartmann
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
- Novo Nordisk Foundation Center for Basic Metabolic ResearchUniversity of CopenhagenCopenhagenDenmark
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12
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Disentangling the relationship between bone turnover and glucose homeostasis: A prospective, population-based twin study. Bone Rep 2021; 14:100752. [PMID: 33665235 PMCID: PMC7900018 DOI: 10.1016/j.bonr.2021.100752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Biochemical markers of bone turnover are lower in patients with type 2 diabetes, which may be explained by genetic variants being associated with type 2 diabetes and bone turnover as well as environmental factors. We hypothesized that bone turnover markers associate with and predict changes in glucose homeostasis after control for genetics and shared environment. Methods 1071 healthy, non-diabetic (at baseline, 1997-2000) adult mono- and dizygotic twins participating in the prospective study GEMINAKAR were reassessed between 2010 and 2012 with clinical evaluation, biochemical tests and oral glucose tolerance test. Fasting bone turnover markers (CTX, P1NP and osteocalcin) were measured. The association between bone turnover, glucose homeostasis and the ability of bone turnover markers to predict changes in glucose homeostasis were assessed in cross-sectional and longitudinal analyses. Analyses were performed both at an individual level and adjusted for shared environmental and genetic factors. Results Glucose levels increased with age, and 33 (3%) participants had developed type 2 diabetes at follow-up. In women, bone turnover markers increased with age, whereas for men only osteocalcin increased with age. Bone turnover markers were not associated with fasting glucose, insulin, or HOMA-IR at baseline or follow-up before or after adjustment for age, sex, BMI, smoking, and use of medication at baseline. Variation in bone turnover markers was mainly explained by unique environmental factors, 70%, 70% and 55% for CTX, P1NP and osteocalcin, respectively, whereas additive genetic factors explained 7%, 13% and 45% of the variation in CTX, P1NP and osteocalcin. Conclusions Bone turnover markers were not associated with baseline plasma glucose levels and did not predict changes in glucose homeostasis. Variation in bone turnover markers is mainly explained by environmental factors, however, compared to CTX and P1NP, genetic factors have a larger impact on osteocalcin levels.
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13
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Sass MR, Wewer Albrechtsen NJ, Pedersen J, Hare KJ, Borbye-Lorenzen N, Kiss K, Vilsbøll T, Knop FK, Poulsen SS, Jørgensen NR, Holst JJ, Ørskov C, Hartmann B. Secretion of parathyroid hormone may be coupled to insulin secretion in humans. Endocr Connect 2020; 9:747-754. [PMID: 32698134 PMCID: PMC7424341 DOI: 10.1530/ec-20-0092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Parathyroid hormone (PTH) is a key hormone in regulation of calcium homeostasis and its secretion is regulated by calcium. Secretion of PTH is attenuated during intake of nutrients, but the underlying mechanism(s) are unknown. We hypothesized that insulin acts as an acute regulator of PTH secretion. METHODS Intact PTH was measured in plasma from patients with T1D and matched healthy individuals during 4-h oral glucose tolerance tests (OGTT) and isoglycemic i.v. glucose infusions on 2 separate days. In addition, expression of insulin receptors on surgical specimens of parathyroid glands was assessed by immunochemistry (IHC) and quantitative PCR (qPCR). RESULTS The inhibition of PTH secretion was more pronounced in healthy individuals compared to patients with T1D during an OGTT (decrementalAUC0-240min: -5256 ± 3954 min × ng/L and -2408 ± 1435 min × ng/L, P = 0.030). Insulin levels correlated significantly and inversely with PTH levels, also after adjusting for levels of several gut hormones and BMI (P = 0.002). Expression of insulin receptors in human parathyroid glands was detected by both IHC and qPCR. CONCLUSION Our study suggests that insulin may act as an acute regulator of PTH secretion in humans.
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Affiliation(s)
- Marie Reeberg Sass
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicolai Jacob Wewer Albrechtsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Jens Pedersen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Endocrinology and Nephrology, Nordsjællands University Hospital, Hillerød, Denmark
| | - Kristine Juul Hare
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nis Borbye-Lorenzen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Tina Vilsbøll
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Filip Krag Knop
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Steen Seier Poulsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Juul Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cathrine Ørskov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Correspondence should be addressed to B Hartmann:
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14
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Madsen JOB, Herskin CW, Zerahn B, Jørgensen NR, Olsen BS, Pociot F, Johannesen J. Decreased markers of bone turnover in children and adolescents with type 1 diabetes. Pediatr Diabetes 2020; 21:505-514. [PMID: 31970841 DOI: 10.1111/pedi.12987] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/09/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIM Adults with type 1 diabetes (T1D) have increased risk of bone fractures and decreased bone mineral density (BMD). Alterations in bone turnover have been suggested as the link between T1D and the impaired bone health. Furthermore, bone turnover has been suggested to have beneficial effects on glucose metabolism. This study aimed at describing bone turnover markers (BTM), and the relationship with glycemic control, in children and adolescents with T1D. METHODS A total of 173 (47% girls) children and adolescents aged 7.7 to 17.5 years with T1D for more than 1 year were included. Participants were evaluated by BMD together with measurements of selected BTM; two formation markers: osteocalcin (OCN) and procollagen type-1 amino-terminal propeptide (P1NP) and one resorption marker, C-terminal cross-linked telopeptide of type-1 collagen (CTX). BTM were converted into Z-scores utilizing new national references. RESULTS Mean OCN Z-score (-0.68 ± 1.31), P1NP Z-score (-0.33 ± 1.03) and CTX Z-score (-0.43 ± 1.10) were all significantly lower than the reference population (P < .001). No associations were seen between BTM and T1D duration. BMD Z-score was comparable to the reference population and associated with none of individual BTMs. CTX Z-score was negatively associated with HbA1c (P = .007) independent of both exogenous and residual endogenous insulin. CONCLUSIONS Markers of bone formation and resorption were decreased in children and adolescents with T1D. CTX Z-score associated negatively with HbA1c adjusted for insulin treatment and endogenous insulin production indicating a potential association between CTX and insulin sensitivity. The long-term consequences of decreased BTM on BMD need further attention.
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Affiliation(s)
| | | | - Bo Zerahn
- Department of Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Denmark.,OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Birthe Susanne Olsen
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark
| | - Flemming Pociot
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Jesper Johannesen
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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15
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Fuglsang-Nielsen R, Rakvaag E, Vestergaard P, Hartmann B, Holst JJ, Hermansen K, Gregersen S, Starup-Linde J. Consumption of nutrients and insulin resistance suppress markers of bone turnover in subjects with abdominal obesity. Bone 2020; 133:115230. [PMID: 31954199 DOI: 10.1016/j.bone.2020.115230] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/13/2019] [Accepted: 01/13/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Abdominal obesity and type 2 diabetes are associated with insulin resistance and low bone turnover along with an increased fracture risk. The mode of action is poorly understood. The bone resorption marker, C-terminal telopeptide type 1 collagen (CTX), and to a lesser extent, the bone formation marker, Procollagen type 1 N-terminal propeptide (P1NP) appear to be inhibited by food consumption. The link between food consumption, insulin resistance and bone turnover remains to be clarified. Primarily we aimed to compare the postprandial CTX, P1NP and PTH responses by two frequently applied methods in assessing metabolic health; oral glucose tolerance test (OGTT) and mixed meal tolerance test. Secondly, we explored the effect of insulin resistance on bone marker responses. METHODS We enrolled 64 subjects with abdominal obesity. Following 10 h of fasting, subjects initially underwent a standard OGTT (300 kcal) and approximately one week later a mixed meal tolerance test (1130 kcal). Circulating CTX, P1NP and PTH were assessed on both days at time = 0, after 30 min and after 90 min for comparison of the two interventions. We analyzed glucose and insulin levels for the assessment of insulin resistance. Additionally, we measured plasma calcium levels along with the gut hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like-peptide 2 (GLP-2) in an attempt to identify possible mediators of the postprandial bone response. RESULTS CTX, P1NP and PTH were suppressed by OGTT and the mixed meal; the latter induced a more pronounced suppression after 90 min. Calcium levels were similar between OGTT and meal. GIP and GLP-2 levels increased after both interventions, although only the meal induced a sustained increase after 90 min. Fasting P1NP was inversely associated with insulin resistance. The meal-induced suppression of P1NP (but not CTX or PTH) was inversely associated with level of insulin resistance. CONCLUSION The acute postprandial suppression of bone turnover markers is extended after ingestion of a mixed meal compared to an OGTT. The response appears to be independent of gender and prompted by a reduction in PTH. The study additionally indicates a possible link between the development of insulin resistance and low bone turnover - which may be of key essence in the development of the fragile bone structure and increased fracture risk demonstrated in subjects with abdominal obesity and T2D.
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Affiliation(s)
- Rasmus Fuglsang-Nielsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark.
| | - Elin Rakvaag
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
| | - Peter Vestergaard
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Denmark; Department of Endocrinology, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences and NNF Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Juul Holst
- Department of Biomedical Sciences and NNF Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
| | - Søren Gregersen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark
| | - Jakob Starup-Linde
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark
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16
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Grammatiki M, Antonopoulou V, Kotsa K. Emerging incretin hormones actions: focus on bone metabolism. MINERVA ENDOCRINOL 2019; 44:264-272. [DOI: 10.23736/s0391-1977.19.03008-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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17
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Parker L, Shaw CS, Byrnes E, Stepto NK, Levinger I. Acute continuous moderate-intensity exercise, but not low-volume high-intensity interval exercise, attenuates postprandial suppression of circulating osteocalcin in young overweight and obese adults. Osteoporos Int 2019; 30:403-410. [PMID: 30306222 DOI: 10.1007/s00198-018-4719-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/31/2018] [Accepted: 09/24/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED Bone remodeling markers (BRMs) are suppressed following the consumption of a meal. Our findings indicate that a single session of continuous moderate-intensity exercise, but not low-volume high-intensity interval exercise, performed 1 h after a meal attenuates the postprandial suppression of BRMs. INTRODUCTION Acute exercise transiently increases BRMs including osteocalcin (tOC) and the undercarboxylated form of osteocalcin (ucOC), a hormone that is implicated in glucose regulation. The effects of acute exercise and exercise-intensity on postprandial levels of tOC and ucOC are unknown. METHODS Twenty-seven adults that were overweight or obese (age 30 ± 1 years; BMI 30 ± 1 kg∙m-2; mean ± SEM) were randomly allocated to perform a single session of low-volume high-intensity interval exercise (LV-HIIE; nine females, five males) or continuous moderate-intensity exercise (CMIE; eightfemales, five males) 1 h after consumption of a standard breakfast. Serum tOC, ucOC, and ucOC/tOC were measured at baseline, 1 h, and 3 h after breakfast consumption on a rest day (no exercise) and the exercise day (exercise 1 h after breakfast). RESULTS Compared to baseline, serum tOC and ucOC were suppressed 3 h after breakfast on the rest day (- 10 ± 1% and - 6 ± 2%, respectively; p < 0.05), whereas ucOC/tOC was elevated (2.5 ± 1%; p = 0.08). Compared to the rest day, CMIE attenuated the postprandial-induced suppression of tOC (rest day - 10 ± 2% versus CMIE - 5 ± 2%, p < 0.05) and ucOC (rest day - 6 ± 4% versus CMIE 11 ± 2%, p < 0.05), and increased postprandial ucOC/tOC (rest day 3 ± 2% versus CMIE 15 ± 1%, p < 0.05). In contrast, LV-HIIE did not alter postprandial tOC, ucOC, or ucOC/tOC (all p > 0.1). CONCLUSIONS Acute CMIE, but not LV-HIIE, attenuates the postprandial-induced suppression of tOC and ucOC. CMIE may be an effective tool to control the circulating levels of BRMs following meal consumption in overweight/obese adults.
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Affiliation(s)
- L Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia.
| | - C S Shaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
| | - E Byrnes
- PathWest QEII Medical Centre, Perth, Australia
| | - N K Stepto
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Melbourne, Australia
- Monash Centre of Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - I Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Melbourne, Australia
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Fuglsang-Nielsen R, Starup-Linde J, Gregersen S, Vestergaard P. The effect of meals on bone turnover - a systematic review with focus on diabetic bone disease. Expert Rev Endocrinol Metab 2018; 13:233-249. [PMID: 30234398 DOI: 10.1080/17446651.2018.1518131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Type 2 diabetes is associated with an increased risk of bone fractures. Bone mineral density (BMD) is increased and bone turnover is low in type 2 diabetes and the increased BMD does not explain the increased fracture risk. However, the low bone turnover may lead to insufficient bone renewal with unrepaired micro-cracks and thus increase fracture risk. Ingestion of food acutely decreases bone resorption markers and the macronutrient composition of meals and meal frequency may influence bone metabolism adversely in subjects with unhealthy eating patterns, e.g., patients with type 2 diabetes. AREAS COVERED The treatment strategy of bone disease in type 2 diabetics is covered in this review. The current management of diabetic bone disease consists of anti-osteoporotic treatment. However, anti-resorptives may further reduce an already low bone turnover with uncertain effects. Furthermore, the acute and long-term effects of meal ingestion, weight loss alone and in combination with exercise as well as the possible underlying mechanisms are covered in this systematic review. EXPERT COMMENTARY Current management of diabetic bone disease is based on principles of anti-osteoporotic treatment in non-diabetic subjects. However, studies are urged to investigate whether anti-resorptives are equally beneficial in type 2 diabetes as in non-diabetic individuals.
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Affiliation(s)
| | - Jakob Starup-Linde
- b Steno Diabetes Center North Jutland , Aalborg University Hospital , Denmark
| | - Søren Gregersen
- a Department of Endocrinology and Internal Medicine , Aarhus University Hospital , Denmark
| | - Peter Vestergaard
- b Steno Diabetes Center North Jutland , Aalborg University Hospital , Denmark
- c Department of Endocrinology , Aalborg University Hospital , Denmark
- d Department of Clinical Medicine , Aalborg University , Denmark
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Stage TB, Christensen MMH, Jørgensen NR, Beck-Nielsen H, Brøsen K, Gram J, Frost M. Effects of metformin, rosiglitazone and insulin on bone metabolism in patients with type 2 diabetes. Bone 2018; 112:35-41. [PMID: 29654849 DOI: 10.1016/j.bone.2018.04.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 03/06/2018] [Accepted: 04/06/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Fracture risk is increased in individuals with type 2 diabetes (T2D). The pathophysiological mechanisms accentuating fracture risk in T2D are convoluted, incorporating factors such as hyperglycaemia, insulinopenia, and antidiabetic drugs. The objectives of this study were to assess whether different insulin regimens, metformin and rosiglitazone influence bone metabolism. We explored if the concentration of metformin and rosiglitazone in blood or improved glycaemic control altered bone turnover. METHODS Two-year clinical trial designed to investigate effects of antidiabetic treatment in 371 T2D patients. Participants were randomized to short or long-acting human insulin (non-blinded) and then further randomized to metformin + placebo, rosiglitazone + placebo, metformin + rosiglitazone or placebo + placebo (blinded). Fasting bone turnover markers (BTM) representing bone resorption (CTX) and formation (PINP) including HbA1c were measured at baseline and after 3, 12 and 24 months. Trough steady-state plasma concentrations of metformin and rosiglitazone were measured after 3, 6 and 9 months of treatment. Associations between treatments and BTMs during the follow-up of the trial were analysed in mixed-effects models that included adjustments for age, gender, BMI, renal function and repeated measures of HbA1c. RESULTS BTMs increased from baseline to month 12 and remained higher at month 24, with CTX and PINP increasing 28.5% and 23.0% (all: p < 0.001), respectively. Allocation of insulin regimens was not associated with different levels of BTMs. Metformin and metformin + rosiglitazone but not rosiglitazone alone were associated with lower bone formation (PINP). Neither metformin nor rosiglitazone plasma concentrations was associated with BTMs. HbA1c was inversely associated with CTX but not P1NP. CONCLUSIONS The choice of insulin treatment is not influencing BTMs, metformin treatment may decrease BTMs, and improvement of glycaemic control may influence bone resorption activity.
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Affiliation(s)
- Tore Bjerregaard Stage
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, USA
| | | | - Niklas Rye Jørgensen
- OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | | | - Kim Brøsen
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jeppe Gram
- Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - Morten Frost
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.
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Maagensen H, Junker AE, Jørgensen NR, Gluud LL, Knop FK, Vilsbøll T. Bone Turnover Markers in Patients With Nonalcoholic Fatty Liver Disease and/or Type 2 Diabetes During Oral Glucose and Isoglycemic Intravenous Glucose. J Clin Endocrinol Metab 2018; 103:2042-2049. [PMID: 29506157 DOI: 10.1210/jc.2018-00176] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/26/2018] [Indexed: 02/07/2023]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes (T2D) and vice versa, and both conditions are associated with an increased risk of fractures and altered bone turnover. Although patients with NAFLD typically suffer from decreased bone mineral density (BMD), T2D is associated with normal to high BMD. The pathophysiology is uncertain but may involve the gut-bone axis. OBJECTIVE We investigated the influence of the gut on glucose-induced changes in plasma bone turnover markers in healthy controls and patients with T2D and/or biopsy-verified NAFLD. DESIGN Cross-sectional cohort study. PATIENTS Patients with NAFLD with normal glucose tolerance, patients with NAFLD and T2D, patients with T2D without liver disease, and healthy controls. INTERVENTIONS Four-hour 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). MAIN OUTCOME MEASURES Collagen type 1 C-telopeptide (CTX), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone. RESULTS Plasma glucose levels achieved during OGTTs were successfully matched on corresponding IIGI days. Patients with NAFLD and T2D exhibited similar CTX suppression during the two glucose challenges (P = 0.46) and pronounced suppression of P1NP during IIGI compared with OGTT. Conversely, remaining groups showed greater (P < 0.05) CTX suppression during OGTT and similar suppression of bone formation markers during IIGI and OGTT. CONCLUSIONS OGTT-induced CTX suppression seems to be impaired in patients with NAFLD and T2D, but preserved in patients with either NAFLD or T2D, suggesting that coexistence of T2D and NAFLD may affect gut-bone axis.
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Affiliation(s)
- Henrik Maagensen
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, University of Copenhagen, Hellerup, Denmark
| | - Anders E Junker
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, University of Copenhagen, Hellerup, Denmark
| | - Niklas R Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lise L Gluud
- Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Filip K Knop
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Conte C, Epstein S, Napoli N. Insulin resistance and bone: a biological partnership. Acta Diabetol 2018; 55:305-314. [PMID: 29333578 DOI: 10.1007/s00592-018-1101-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/03/2018] [Indexed: 01/27/2023]
Abstract
Despite a clear association between type 2 diabetes (T2D) and fracture risk, the pathogenesis of bone fragility in T2D has not been clearly elucidated. Insulin resistance is the primary defect in T2D. Insulin signalling regulates both bone formation and bone resorption, but whether insulin resistance can affect bone has not been established. On the other hand, evidence exists that bone might play a role in the regulation of glucose metabolism. This article reviews the available experimental and clinical evidence on the interplay between bone and insulin resistance. Interestingly, a bilateral relationship between bone and insulin resistance seems to exist that unites them in a biological partnership.
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Affiliation(s)
- Caterina Conte
- Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20163, Milan, Italy.
| | - Solomon Epstein
- Division of Endocrinology, Mount Sinai School of Medicine, New York, NY, USA
| | - Nicola Napoli
- Division of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
- Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
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Frost M, Balkau B, Hatunic M, Konrad T, Mingrone G, Højlund K. The relationship between bone turnover and insulin sensitivity and secretion: Cross-sectional and prospective data from the RISC cohort study. Bone 2018; 108:98-105. [PMID: 29305997 DOI: 10.1016/j.bone.2017.12.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/18/2017] [Accepted: 12/29/2017] [Indexed: 01/27/2023]
Abstract
Bone metabolism appears to influence insulin secretion and sensitivity, and insulin promotes bone formation in animals, but similar evidence in humans is limited. The objectives of this study are to explore if bone turnover markers were associated with insulin secretion and sensitivity and to determine if bone turnover markers predict changes in insulin secretion and sensitivity. The study population encompassed 576 non-diabetic adult men with normal glucose tolerance (NGT; n=503) or impaired glucose regulation (IGR; n=73). Baseline markers of bone resorption (CTX) and formation (P1NP) were determined in the fasting state and after a 2-h hyperinsulinaemic, euglycaemic clamp. An intravenous glucose tolerance test (IVGTT) and a 2-h oral glucose tolerance test (OGTT) were performed at baseline, and the OGTT was repeated after 3years. There were no differences in bone turnover marker levels between NGT and IGR. CTX and P1NP levels decreased by 8.0% (p<0.001) and 1.9% (p<0.01) between baseline and steady-state during the clamp. Fasting plasma glucose was inversely associated with CTX and P1NP both before and after adjustment for recruitment centre, age, BMI, smoking and physical activity. However, baseline bone turnover markers were neither associated with insulin sensitivity (assessed using hyperinsulinaemic euglycaemic clamp and OGTT) nor with insulin secretion capacity (based on IVGTT and OGTT) at baseline or at follow-up. Although inverse associations between fasting glucose and markers of bone turnover were identified, this study cannot support an association between insulin secretion and sensitivity in healthy, non-diabetic men.
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Affiliation(s)
- Morten Frost
- Endocrine Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Beverley Balkau
- CESP, Faculty of Medicine - University Paris-South, Faculty of Medicine - University Versailles-St Quentin, INSERM U1018, University Paris-Saclay, Villejuif, France
| | - Mensud Hatunic
- Endocrinology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Thomas Konrad
- Clinic of Pediatrics I, Johann Wolfgang Goethe Universität am Main, Frankfurt, Germany
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy; Diabetes and Nutritional Sciences, King's College London, London, UK
| | - Kurt Højlund
- Endocrine Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Section of Molecular Diabetes & Metabolism, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Christensen MB, Lund A, Calanna S, Jørgensen NR, Holst JJ, Vilsbøll T, Knop FK. Glucose-Dependent Insulinotropic Polypeptide (GIP) Inhibits Bone Resorption Independently of Insulin and Glycemia. J Clin Endocrinol Metab 2018; 103:288-294. [PMID: 29099978 DOI: 10.1210/jc.2017-01949] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/27/2017] [Indexed: 01/29/2023]
Abstract
CONTEXT The gut hormone glucose-dependent insulinotropic polypeptide (GIP) causes postprandial insulin release and inhibits bone resorption assessed by carboxy-terminal collagen crosslinks (CTX). OBJECTIVE To study if GIP affects bone homeostasis biomarkers independently of insulin release and glycemic level. DESIGN Randomized, double-blinded, crossover study with 5 study days. PATIENTS Ten male C-peptide-negative patients with type 1 diabetes. INTERVENTIONS On 3 matched days with "low glycemia" (plasma glucose in the interval 3 to 7 mmol/L for 120 minutes), we administered intravenous (IV) GIP (4 pmol × kg-1 × min-1), glucagon-like peptide 1 (1 pmol × kg-1 × min-1), or placebo (saline), and on 2 matched days with "high glycemia" (plasma glucose 12 mmol/L for 90 minutes), we administered either GIP or saline. MAIN OUTCOME MEASURES CTX, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone (PTH). RESULTS During low glycemia: GIP progressively suppressed CTX from baseline by up to 59 ± 18% compared with 24 ± 10% during saline infusion (P < 0.0001). Absolute values of P1NP and PTH did not differ between days. During high glycemia: GIP suppressed CTX from baseline by up to 59 ± 19% compared with 7 ± 9% during saline infusion (P < 0.0001). P1NP did not differ between days. GIP suppressed PTH after 60 minutes compared with saline (P < 0.01), but this difference disappeared after 90 minutes. CONCLUSIONS Short-term GIP infusions robustly reduce bone resorption independently of endogenous insulin secretion and during both elevated and low plasma glucose, but have no effect on P1NP or PTH after 90 minutes.
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Affiliation(s)
- Mikkel B Christensen
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Asger Lund
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Salvatore Calanna
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Niklas R Jørgensen
- Department of Clinical Chemistry, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
- Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, University of Copenhagen, Gentofte, Denmark
| | - Filip K Knop
- Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Tonks KT, White CP, Center JR, Samocha-Bonet D, Greenfield JR. Bone Turnover Is Suppressed in Insulin Resistance, Independent of Adiposity. J Clin Endocrinol Metab 2017; 102:1112-1121. [PMID: 28324004 DOI: 10.1210/jc.2016-3282] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023]
Abstract
CONTEXT The contribution of insulin resistance vs adiposity to bone mineral density (BMD), bone turnover, and fractures in humans remains unclear. OBJECTIVE To evaluate BMD and bone turnover markers (BTMs) in lean (n = 18) and overweight/obese individuals with (n = 17) and without (n = 34, insulin-sensitive [Obsensitive, n=15] or insulin-resistant [Obresistant, n=19] by homeostasis model assessment insulin resistance) diabetes mellitus. DESIGN Observational study. OUTCOME MEASURES Insulin sensitivity was assessed using the hyperinsulinemic-euglycemic clamp; whole body BMD and fat mass (FM) using dual energy X-ray absorptiometry; and by measurement of BTMs [osteocalcin (OC), procollagen type 1 N-terminal propeptide (P1NP), and collagen type 1 cross-linked C-terminal telopeptide (CTx)], with the patient fasting and during clamp hyperinsulinemia. RESULTS Fasting BTMs correlated with glucose infusion rate/fat-free mass (GIR/FFM) and adiponectin and, inversely, with fasting insulin and visceral fat (P ≤ 0.04 for all). Obsensitive, Obresistant, and diabetic individuals were matched by their FM percentage. Clamp GIR/FFM was similar in the lean and Obsensitive subjects (P = 1) and approximately twofold greater (P < 0.001) than in the Obresistant and diabetic subjects. BMD was greater in Obresistant than in Obsensitive (P = 0.04) and lean (P = 0.001) subjects. At baseline, compared with Obsensitive and lean subjects, Obresistant and diabetic individuals had lower OC, P1NP, and CTx levels. This reached statistical significance for Obresistant vs lean and Obresistant vs Obsensitive for both OC and CTx and for diabetic vs lean for CTx (P ≤ 0.04 for all). During hyperinsulinemia, lean individuals suppressed CTx more than did diabetic individuals (P = 0.03). On multiple regression analysis, visceral adiposity explained 16.7% and 19.3% of the baseline OC and CTx variability, respectively. CONCLUSIONS Increased visceral adiposity and higher fasting insulin in insulin-resistant states are associated with lower fasting OC and CTx and failure to further suppress with more insulin.
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Affiliation(s)
- Katherine T Tonks
- Diabetes and Obesity Research Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
- Department of Endocrinology and Diabetes, St Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia
- University of New South Wales Faculty of Medicine, University of New South Wales Sydney, New South Wales 2052, Australia
| | - Christopher P White
- Department of Endocrinology and Metabolism, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia
- University of New South Wales Faculty of Medicine, University of New South Wales Sydney, New South Wales 2052, Australia
| | - Jacqueline R Center
- Department of Endocrinology and Diabetes, St Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
- University of New South Wales Faculty of Medicine, University of New South Wales Sydney, New South Wales 2052, Australia
| | - Dorit Samocha-Bonet
- Diabetes and Obesity Research Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
- University of New South Wales Faculty of Medicine, University of New South Wales Sydney, New South Wales 2052, Australia
| | - Jerry R Greenfield
- Diabetes and Obesity Research Group, Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
- Department of Endocrinology and Diabetes, St Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia
- University of New South Wales Faculty of Medicine, University of New South Wales Sydney, New South Wales 2052, Australia
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Intestinal Incretins and the Regulation of Bone Physiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1033:13-33. [PMID: 29101649 DOI: 10.1007/978-3-319-66653-2_2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although originally identified as modulators of nutrient absorption, the gut hormones gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and glucagon-like peptide-2 (GLP-2) have also been found to play an important role in the regulation of bone turnover. These "incretin" hormones promote bone anabolism by stimulating osteoblast differentiation as well as increasing osteoblast longevity. In addition, GIP and perhaps GLP-2 attenuate the activity of osteoclastic cells, leading to a net increase in bone deposition and ultimately increasing bone mass. Studies have demonstrated that these hormones are important for bone mineralization and overall bone quality and function evolutionarily as important nutritional links signaling nutrient availability for skeletal anabolic functions. Accordingly, these entero-osseous hormones (EOH) have therapeutic potential for the management of osteoporosis. Although this chapter primarily focuses on skeletal effects of these incretin hormones, the GIP, GLP-1, and GLP-2 receptors are actually widely expressed throughout the body. Therefore, we will also briefly discuss these extraosseous receptors/effects and how they may indirectly impact the skeleton.
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26
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Protein/amino-acid modulation of bone cell function. BONEKEY REPORTS 2016; 5:827. [PMID: 28149508 PMCID: PMC5238414 DOI: 10.1038/bonekey.2016.58] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/24/2016] [Indexed: 01/07/2023]
Abstract
Nutrients (protein, carbohydrates and fats) have traditionally been thought of as fuels simply providing the energy for cellular metabolic activity. According to the classic view, if nutrients are available, then anabolic pathways are activated, and if nutrients are not available, catabolic pathways are activated. However, it is becoming increasingly clear that nutrient effects on bone cells (stem cells, osteoblasts and osteoclasts) are complex, some nutrients promote bone formation, whereas others interfere with bone formation or actually promote bone break down. At an organ level, nutrient intake can suppress bone breakdown and modulate the activity of the calcium/vitamin D/parathyroid hormone axis. At a cellular level, nutrient intake can impact cellular energetics either through a direct mechanism (binding or uptake of the nutrient into the cell) or indirect (by elevating nutrient-related hormones such as insulin, insulin-like growth factor 1 or incretin hormones). It is also becoming clear that within a nutrient class (for example, protein), individual components (that is, amino acids) can have markedly different effects on cell function and impact bone formation. The focus of this review will be on one nutrient class in particular, dietary protein. As the prevalence of inadequate dietary protein intake increases with age, these findings may have translational implications as to the optimal dietary protein content in the setting of age-associated bone loss.
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Schwetz V, Lerchbaum E, Schweighofer N, Hacker N, Trummer O, Borel O, Pieber TR, Chapurlat R, Obermayer-Pietsch B. Osteocalcin levels on oral glucose load in women being investigated for polycystic ovary syndrome. Endocr Pract 2016; 20:5-14. [PMID: 24013985 DOI: 10.4158/ep13110.or] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Osteocalcin (OC) might play a hormone-like role in energy metabolism and the regulatory circuit between the pancreas and osteoblasts. Effects of a 75-g oral glucose tolerance test (OGTT) on total OC, undercarboxylated (ucOC), and carboxylated osteocalcin (cOC) in insulin-resistant (IR) and noninsulin-resistant (nIR) premenopausal women was evaluated, and the relationships of changes in OC, ucOC, and cOC with area under the curve (AUC) insulin and the Matsuda index were examined. METHODS In this cross-sectional study, 105 premenopausal women underwent OGTT; 18 were IR (homeostatic model assessment of insulin resistance [HOMA-IR] > 2.6; (2 with type 2 diabetes, 2 with impaired glucose tolerance), and 87 were nIR (3 with impaired glucose tolerance). Changes in total OC, ucOC, and cOC were evaluated 60 and 120 minutes after glucose loading. RESULTS At baseline, IR subjects had significantly lower levels of total OC, cOC, and ucOC. In nIR women, total OC decreased by 19% from 18.0 ng/mL (14.5-24.7) at baseline to 14.6 ng/mL (10.9-17.8) after 120 minutes, ucOC decreased by 22% from 3.2 ng/mL (2.1-4.5) to 2.5 ng/mL (1.7-3.5), and cOC decreased by 26% from 14.9 ng/mL (12.1-20.4) to 11.1 ng/mL (9.0-14.5) (P < .001, respectively). No significant decreases were noted in IR subjects. The declines in OC and cOC predicted AUCinsulin (ΔOC: β = 0.301, P = .001; ΔcOC: β = 0.315, P < .001) and the Matsuda index (ΔOC: β = -0.235, P = .003; ΔcOC: β = -0.245, P = .002). CONCLUSIONS Glucose intake lowers levels of OC, ucOC, and cOC in nIR women, the extent of which predicts IR and insulin sensitivity in premenopausal women. OC parameters seem suppressed in IR women. There might be a differential osteoblast response to oral glucose in IR and nIR women, with OC reflecting this finding.
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Affiliation(s)
- Verena Schwetz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Natascha Schweighofer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nicole Hacker
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Olivia Trummer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Olivier Borel
- Hôpital Edouard Herriot, Université de Lyon, INSERM UMR 1033, France
| | - Thomas R Pieber
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Roland Chapurlat
- Hôpital Edouard Herriot, Université de Lyon, INSERM UMR 1033, France
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Xiang SK, Wan JB, Jiang XH, Zhu YH, Ma JH, Hua F. Effect of Intravenous Glucose Tolerance Test on Bone Turnover Markers in Adults with Normal Glucose Tolerance. Med Sci Monit 2016; 22:2602-7. [PMID: 27447783 PMCID: PMC4968615 DOI: 10.12659/msm.896469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background It is well known that enteral nutrients result in acute suppression of bone turnover markers (BTMs), and incretin hormones are believed to play a significant role in this physiological skeletal response. However, there is limited research exploring the impact of parenteral nutrients on BTMs. Our aim was to assess the influence of intravenous glucose on BTMs in adults with normal glucose tolerance (NGT). Material/Methods We conducted 1-h intravenous glucose tolerance test (IVGTT) in 24 subjects with NGT. Blood samples were collected before and 5, 10, 15, 20, 30, 60 min after administration of glucose, then serum levels of bone formation marker procollagen type I N-terminal propeptide (P1NP) and resorption marker C-terminal cross-linking telopeptides of collagen type I (CTX) were measured. Results During IVGTT, the fasting CTX level fell gradually and reached a nadir of 80.4% of the basal value at 60 min. Conversely, the fasting P1NP level decreased mildly and reached a nadir of 90.6% of the basal value at 15 min, then gradually increased and reached 96.6% at 60 min. The CTX-to-P1NP ratio increased slightly and reached a peak of 104.3% of the basal value at 10 min, then fell gradually and reached a nadir of 83% at 60 min. Conclusions Our study indicates that intravenous glucose results in an acute suppression of BTMs in the absence of incretin hormones. The mechanism responsible for this needs further investigation.
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Affiliation(s)
- Shou-Kui Xiang
- Department of Endocrinology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Jing-Bo Wan
- Department of Endocrinology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Xiao-Hong Jiang
- Department of Endocrinology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Yong-Hua Zhu
- Department of Clinical Laboratory Medicine, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Jin-Hong Ma
- Department of Clinical Laboratory Medicine, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
| | - Fei Hua
- Department of Endocrinology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China (mainland)
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Lavet C, Martin A, Linossier MT, Vanden Bossche A, Laroche N, Thomas M, Gerbaix M, Ammann P, Fraissenon A, Lafage-Proust MH, Courteix D, Vico L. Fat and Sucrose Intake Induces Obesity-Related Bone Metabolism Disturbances: Kinetic and Reversibility Studies in Growing and Adult Rats. J Bone Miner Res 2016; 31:98-115. [PMID: 26175082 DOI: 10.1002/jbmr.2596] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/19/2015] [Accepted: 06/29/2015] [Indexed: 01/01/2023]
Abstract
Metabolic and bone effects were investigated in growing (G, n = 45) and mature (M, n = 45) rats fed a high-fat/high-sucrose diet (HFS) isocaloric to the chow diet of controls (C, n = 30 per group). At week 19, a subset of 15 rats in each group (HFS or C, at both ages) was analyzed. Then one-half of the remaining 30 HFS rats in each groups continued HFS and one-half were shifted to C until week 27. Although no serum or bone marrow inflammation was seen, HFS increased visceral fat, serum leptin and insulin at week 19 and induced further alterations in lipid profile, serum adiponectin, and TGFβ1, TIMP1, MMP2, and MMP9, suggesting a prediabetic phenotype and cardiovascular dysfunction at week 27 more pronounced in M than G. These events were associated with dramatic reduction of osteoclastic and osteoid surfaces with accelerated mineralizing surfaces in both HFS age groups. Mineral metabolism and its major regulators were disturbed, leading to hyperphosphatemia and hypocalcemia. These changes were associated with bone alterations in the weight-bearing tibia, not in the non-weight-bearing vertebra. Indeed in fat rats, tibia trabecular bone accrual increased in G whereas loss of trabecular bone in M was alleviated. At diaphysis cortical porosity increased in G and even more in M at week 27. After the diet switch, metabolic and bone cellular disturbances fully reversed in G, but not in M. Trabecular benefit of the obese was preserved in both age groups and in M the age-related bone loss was even lighter after the diet switch than in prolonged HFS. At the diaphysis, cortical porosity normalized in G but not in M. Hypocalcemia in G and M was irreversible. Thus, the mild metabolic syndrome induced by isocaloric HFS is able to alter bone cellular activities and mineral metabolism, reinforce trabecular bone, and affect cortical bone porosity in an irreversible manner in older rats.
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Affiliation(s)
- Cédric Lavet
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Aline Martin
- Division of Nephrology, Center for Translational Metabolism and Health Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Marie-Thérèse Linossier
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Arnaud Vanden Bossche
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Norbert Laroche
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Mireille Thomas
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Maude Gerbaix
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Patrick Ammann
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospital, Geneva, Switzerland
| | - Antoine Fraissenon
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Marie-Hélène Lafage-Proust
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
| | - Daniel Courteix
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Blaise Pascal University, Clermont University, Clermont Ferrand, France
| | - Laurence Vico
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1059, Laboratoire de Biologie intégrative du Tissu Osseux, Lyon University, Saint-Étienne, France
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Ivaska KK, Heliövaara MK, Ebeling P, Bucci M, Huovinen V, Väänänen HK, Nuutila P, Koistinen HA. The effects of acute hyperinsulinemia on bone metabolism. Endocr Connect 2015; 4:155-62. [PMID: 26047829 PMCID: PMC4496528 DOI: 10.1530/ec-15-0022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/05/2015] [Indexed: 12/20/2022]
Abstract
Insulin signaling in bone-forming osteoblasts stimulates bone formation and promotes the release of osteocalcin (OC) in mice. Only a few studies have assessed the direct effect of insulin on bone metabolism in humans. Here, we studied markers of bone metabolism in response to acute hyperinsulinemia in men and women. Thirty-three subjects from three separate cohorts (n=8, n=12 and n=13) participated in a euglycaemic hyperinsulinemic clamp study. Blood samples were collected before and at the end of infusions to determine the markers of bone formation (PINP, total OC, uncarboxylated form of OC (ucOC)) and resorption (CTX, TRAcP5b). During 4 h insulin infusion (40 mU/m(2) per min, low insulin), CTX level decreased by 11% (P<0.05). High insulin infusion rate (72 mU/m(2) per min) for 4 h resulted in more pronounced decrease (-32%, P<0.01) whereas shorter insulin exposure (40 mU/m(2) per min for 2 h) had no effect (P=0.61). Markers of osteoblast activity remained unchanged during 4 h insulin, but the ratio of uncarboxylated-to-total OC decreased in response to insulin (P<0.05 and P<0.01 for low and high insulin for 4 h respectively). During 2 h low insulin infusion, both total OC and ucOC decreased significantly (P<0.01 for both). In conclusion, insulin decreases bone resorption and circulating levels of total OC and ucOC. Insulin has direct effects on bone metabolism in humans and changes in the circulating levels of bone markers can be seen within a few hours after administration of insulin.
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Affiliation(s)
- Kaisa K Ivaska
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Maikki K Heliövaara
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Pertti Ebeling
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Marco Bucci
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Ville Huovinen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - H Kalervo Väänänen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Pirjo Nuutila
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
| | - Heikki A Koistinen
- Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland Department of Cell Biology and AnatomyInstitute of Biomedicine, University of Turku, FI-20520 Turku, FinlandDepartment of MedicineUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandTurku PET CentreUniversity of Turku, Turku, FinlandDepartment of RadiologyUniversity of Turku, Turku, FinlandMedical Imaging Centre of Southwest FinlandTurku University Hospital, Turku, FinlandDepartment of EndocrinologyTurku University Hospital, Turku, FinlandAbdominal Center: EndocrinologyUniversity of Helsinki and Helsinki University Central Hospital, Helsinki, FinlandMinerva Foundation Institute for Medical ResearchHelsinki, Finland
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The effect of hyperinsulinaemic-euglycaemic clamp and exercise on bone remodeling markers in obese men. BONEKEY REPORTS 2015; 4:731. [PMID: 26331010 DOI: 10.1038/bonekey.2015.100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/23/2015] [Indexed: 01/16/2023]
Abstract
Bone remodelling markers (BRMs) are suppressed following a glucose load and during glucose infusion. As exercise increases indices of bone health and improves glucose handling, we hypothesised that, at rest, hyperinsulinaemic-euglycaemic clamp will suppress BRMs in obese men and that exercise prior to the clamp will prevent this suppression. Eleven obese nondiabetic men (age 58.1±2.2 years, body mass index=33.1±1.4 kg m(-2) mean±s.e.m.) had a hyperinsulinaemic-euglycaemic clamp (HEC) at rest (Control) and 60 min post exercise (four bouts × 4 min cycling at 95% of hazard ratiopeak). Blood samples were analysed for serum insulin, glucose, bone formation markers, total osteocalcin (tOC) and procollagen type 1 N-terminal propeptide (P1NP), and the bone resorption marker, β-isomerised C-terminal telopeptides (β-CTx). In the control trial (no exercise), tOC, P1NP and β-CTx decreased with HEC by >10% compared with baseline (P<0.05). Fasting serum glucose, but not insulin, tended to correlate negatively with the BRMs (β range -0.57 to -0.66, p range 0.051-0.087). β-CTx, but not OC or P1NP, increased within 60 min post exercise (∼16%, P<0.01). During the post-exercise HEC, the glucose infusion rate was ∼30% higher compared with the no exercise trial. Despite this, BRMs were only suppressed to a similar extent as in the control session (10%). HEC suppressed BRMs in obese men. Exercise did not prevent this suppression of BRMs by HEC but improved glucose handling during the trial. It remains to be tested whether an exercise intervention of longer duration may be able to prevent the effect of HEC on bone remodelling.
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Sale C, Varley I, Jones TW, James RM, Tang JCY, Fraser WD, Greeves JP. Effect of carbohydrate feeding on the bone metabolic response to running. J Appl Physiol (1985) 2015; 119:824-30. [PMID: 26251510 PMCID: PMC4593812 DOI: 10.1152/japplphysiol.00241.2015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 07/30/2015] [Indexed: 11/22/2022] Open
Abstract
Bone resorption is increased after running, with no change in bone formation. Feeding during exercise might attenuate this increase, preventing associated problems for bone. This study investigated the immediate and short-term bone metabolic responses to carbohydrate (CHO) feeding during treadmill running. Ten men completed two 7-day trials, once being fed CHO (8% glucose immediately before, every 20 min during, and immediately after exercise at a rate of 0.7 g CHO·kg body mass−1·h−1) and once being fed placebo (PBO). On day 4 of each trial, participants completed a 120-min treadmill run at 70% of maximal oxygen consumption (V̇o2 max). Blood was taken at baseline (BASE), immediately after exercise (EE), after 60 (R1) and 120 (R2) min of recovery, and on three follow-up days (FU1-FU3). Markers of bone resorption [COOH-terminal telopeptide region of collagen type 1 (β-CTX)] and formation [NH2-terminal propeptides of procollagen type 1 (P1NP)] were measured, along with osteocalcin (OC), parathyroid hormone (PTH), albumin-adjusted calcium (ACa), phosphate, glucagon-like peptide-2 (GLP-2), interleukin-6 (IL-6), insulin, cortisol, leptin, and osteoprotogerin (OPG). Area under the curve was calculated in terms of the immediate (BASE, EE, R1, and R2) and short-term (BASE, FU1, FU2, and FU3) responses to exercise. β-CTX, P1NP, and IL-6 responses to exercise were significantly lower in the immediate postexercise period with CHO feeding compared with PBO (β-CTX: P = 0.028; P1NP: P = 0.021; IL-6: P = 0.036), although there was no difference in the short-term response (β-CTX: P = 0.856; P1NP: P = 0.721; IL-6: P = 0.327). No other variable was significantly affected by CHO feeding during exercise. We conclude that CHO feeding during exercise attenuated the β-CTX and P1NP responses in the hours but not days following exercise, indicating an acute effect of CHO feeding on bone turnover.
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Affiliation(s)
- Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom;
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Thomas W Jones
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ruth M James
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Jonathan C Y Tang
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - William D Fraser
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom; Norfolk and Norwich University Hospital, Norwich, United Kingdom; and
| | - Julie P Greeves
- Department of Occupational Medicine, HQ Army Recruiting and Training Division, Upavon, United Kingdom
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Abstract
In this review, we will first discuss the concept of bone strength and introduce how fat at different locations, including the bone marrow, directly or indirectly regulates bone turnover. We will then review the current literature supporting the mechanistic relationship between marrow fat and bone and our understanding of the relationship between body fat, body weight, and bone with emphasis on its hormonal regulation. Finally, we will briefly discuss the importance and challenges of accurately measuring the fat compartments using non-invasive methods. This review highlights the complex relationship between fat and bone and how these new concepts will impact our diagnostic and therapeutic approaches in the very near future.
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Affiliation(s)
- Richard Kremer
- McGill University, Montreal, QC, Canada
- *Correspondence: Richard Kremer,
| | - Vicente Gilsanz
- Children’s Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Dan S, Aditya P, Samanta M, Jothimalar R, Soundarajan P. Effect of glycemic control on intact parathyroid hormone level in end stage renal disease patients on maintenance hemodialysis. Diabetes Res Clin Pract 2014; 105:352-5. [PMID: 25015316 DOI: 10.1016/j.diabres.2014.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 02/28/2014] [Accepted: 04/02/2014] [Indexed: 11/25/2022]
Abstract
AIMS We evaluated the relationship between iPTH levels and glycemic control in patients with diabetes and end stage renal disease (ESRD) on maintenance hemodialysis (MHD). METHODS The study included 98 subjects with ESRD and type 2 diabetes aged 30-75 years who were on MHD. These were divided into two groups--patients with HbA1c >7.0 (53 mmol/mol) (poor glycemic control group) and patients with HbA1c <7.0 (53 mmol/mol) (good glycemic control group). All patients had been on regular bicarbonate haemodialysis for more than 6 months using polysulfone membrane dialyzer; 4 h per episode 3 times/week, with a dialysis fluid of 3.0 mEq/L of calcium concentration. 1-α-(OH)D3 and calcium carbonate were used routinely in all patients. The contribution of each relevant biological parameter to serum iPTH level was assessed using multiple regression test. RESULTS Poor glycemic control was associated with reduced serum iPTH level and good glycemic control with higher serum iPTH. The serum HbA1c level was significantly correlated with the serum iPTH level (p=0.0003). CONCLUSIONS Glycemic control is a significant determinant of iPTH level in diabetic ESRD patients on MHD.
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Affiliation(s)
- Subhasish Dan
- Department of Biochemistry, Medical College, 88, College Street, Kolkata 700073, West Bengal, India.
| | - Papia Aditya
- Tejganj High School, Nutanganj, Burdwan 713103, West Bengal, India
| | - Maitreya Samanta
- Department of Environmental Health Engineering, Sri Ramachandra University, Porur, Chennai 600116, Tamil Nadu, India
| | - R Jothimalar
- Department of Biochemistry, Sri Ramachandra University, Porur, Chennai 600116, Tamil Nadu, India
| | - P Soundarajan
- Department of Nephrology, Sri Ramachandra University, Porur, Chennai 600116, Tamil Nadu, India
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Ewang-Emukowhate M, Alaghband-Zadeh J, Vincent RP, Sherwood RA, Moniz CF. An association between post-meal bile acid response and bone resorption in normal subjects. Ann Clin Biochem 2013; 50:558-63. [DOI: 10.1177/0004563213482891] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The mechanism surrounding bone suppression after a meal may involve several mediators, but is yet to be clarified. Bile acids (BA) function as signalling molecules in response to feeding, and may be directly involved in bone suppression acutely after a meal. The aim of this study was to test the hypothesis that BA are involved in the acute bone suppression observed after a meal. Methods A prospective study in which samples collected from volunteers fed a 400 Kcal test meal after an overnight fast were analysed for parathyroid hormone (PTH), BA, and carboxyterminal of type 1 collagen telopeptide (CTX). The study was carried out in 10 healthy male volunteers. Ethical approval was obtained from the Local Research and Ethics Committee at King's College Hospital. Results Total BA, glycine conjugated bile acids (GCBA), PTH and CTX showed a response to meal ingestion. There was a negative correlation between percentage change in PTH and CTX ( R2 = −0.82, P = 0.004), and between PTH and GCBA ( R2 = −0.39, P = 0.005). Conclusion This study demonstrated an association between GCBA and PTH suppression after a meal. The drop in PTH concentration after a meal may be responsible for the suppression of bone resorption as observed by the decrease in CTX concentration.
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Affiliation(s)
- M Ewang-Emukowhate
- Department of Clinical Biochemistry, King's College Hospital, London, UK
| | - J Alaghband-Zadeh
- Department of Clinical Biochemistry, King's College Hospital, London, UK
| | - RP Vincent
- Department of Clinical Biochemistry, King's College Hospital, London, UK
| | - RA Sherwood
- Department of Clinical Biochemistry, King's College Hospital, London, UK
| | - CF Moniz
- Department of Clinical Biochemistry, King's College Hospital, London, UK
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Paldánius PM, Ivaska KK, Hovi P, Andersson S, Eriksson JG, Väänänen K, Kajantie E, Mäkitie O. Total and carboxylated osteocalcin associate with insulin levels in young adults born with normal or very low birth weight. PLoS One 2013; 8:e63036. [PMID: 23658795 PMCID: PMC3643916 DOI: 10.1371/journal.pone.0063036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 03/27/2013] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Osteocalcin (OC), a bone-derived protein, has been implicated in the regulation of glucose and energy metabolism. Young adults born with very low birth weight (VLBW) have altered glucose regulation and lower bone mineral density (BMD) compared with those born at term. The aim of this study was to explore the association between bone and glucose metabolism in healthy young adults born prematurely or at term. METHODS The cohort of this cross-sectional study comprised 332 non-diabetic young adults (age 18 to 27 years) born either preterm with VLBW (n = 163) or at term (n = 169). OC, carboxylated osteocalcin (cOC) and markers of glucose metabolism were measured at fasting and after a 75-g oral glucose tolerance test (OGTT). RESULTS VLBW adults were shorter, had lower BMD (p<0.001) and higher fasting OC (p = 0.027) and cOC (p = 0.005) than term-born subjects. They also had higher 2-hour insulin (p = 0.001) and glucose (p = 0.037) concentrations. OGTT induced a significant reduction in OC (p<0.001), similar in both groups. OC reduction was not associated with OGTT-induced increases in insulin (p = 0.54). However, fasting total OC and cOC correlated negatively with fasting insulin after adjustment for age, gender, BMD and VLBW status (r = -0.182, p = 0.009 and r = -0.283, p<0.001, respectively). CONCLUSION Adults born with VLBW have higher OC and cOC than their peers born at term. This may in part reflect the mechanisms that underlie their lower BMD and decreased insulin sensitivity. Serum OC appears to be negatively associated with long-term glucose regulation whereas acute changes during OGTT may be mediated via other mechanisms.
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Affiliation(s)
- Päivi M Paldánius
- Children's Hospital, Helsinki University Central Hospital, and Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.
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Stanley T, Bredella MA, Pierce L, Misra M. The ratio of parathyroid hormone to vitamin D is a determinant of cardiovascular risk and insulin sensitivity in adolescent girls. Metab Syndr Relat Disord 2012; 11:56-62. [PMID: 23130887 DOI: 10.1089/met.2012.0102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin D insufficiency and higher testosterone are common in obese girls and may adversely affect glucose homeostasis and cardiovascular risk. Data are conflicting regarding the impact of parathyroid hormone (PTH) on these factors. Our objective was to determine associations of 25-hydroxyvitamin D (25-OHD), PTH, and testosterone with measures of glucose homeostasis and cardiovascular risk in adolescent girls after controlling for regional adiposity, with the hypothesis that lower 25-OHD, a higher PTH or PTH/25-OHD ratio, and higher testosterone would be associated with lower insulin sensitivity and greater cardiovascular risk. METHODS A total of 15 obese girls and 15 matched normal weight controls (12-18 years) underwent fasting measurements of 25-OHD, PTH, testosterone, sex hormone-binding globulin (SHBG), high-sensitivity C-reactive protein (hsCRP), oral glucose tolerance testing, and quantification of visceral (VAT) and subcutaneous (SAT) fat by magnetic resonance imaging (MRI). RESULTS There were no associations of 25-OHD with measures of glucose homeostasis or hsCRP. In contrast, PTH and PTH/25-OHD were associated negatively with homeostasis model assessment of insulin resistance (HOMA-IR) and positively with quantitative insulin sensitivity check index (QUICKI) in obese girls but not controls. These associations remained significant after controlling for body mass index standard deviation score (BMI-SDS), but not for VAT. On regression modeling, PTH/25-OHD was positively associated with hsCRP after controlling for BMI-SDS or VAT. Free testosterone positively predicted the corrected insulin response. CONCLUSIONS In obese girls, PTH/25-OHD is positively associated with measures of insulin sensitivity and hsCRP. Further studies are needed to investigate the relationship between PTH and glucose homeostasis in obesity.
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Affiliation(s)
- Takara Stanley
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
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Carnevale V, Inglese M, Annese MA, De Matthaeis A, Santini SA, Frusciante V, Fontana A, Copetti M, Pellegrini F, D'Amico G. Vitamin D and parameters of calcium homeostasis in inpatients with and without Type 2 diabetes mellitus. J Endocrinol Invest 2012; 35:853-8. [PMID: 22293170 DOI: 10.3275/8236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM We investigated inpatients with and without Type 2 diabetes mellitus, aged over 60 yr, to compare their vitamin D status and calcium homeostatic parameters. MATERIALS AND METHODS We studied 140 patients consecutively admitted to our Internal Medicine Unit during the year 2010 (61 from November to April, 79 from May to October). The sample encompassed 70 patients with and 70 without diabetes. At admission we measured serum calcium (Ca), phosphate (P), sodium (Na), potassium (K), creatinine (Cr), alkaline phosphatase total activity (AP), albumin adjusted serum calcium (Caalb adj), 25 hydroxy-vitamin D (25OHD), PTH, and 24-h urinary Na/Cr (uNa/Cr), K/Cr (uK/Cr), Ca/Cr (uCa/Cr), P/Cr (uP/Cr) ratios, and calcium excretion (Ca ex). RESULTS 25OHD levels of patients with and without diabetes did not significantly differ. In patients without diabetes recruited from November to April, 25OHD levels were significantly lower than those from May to October, whilst patients with diabetes did not show a significant seasonal variation. PTH had opposite non-significant seasonal variations, and negatively correlated with 25OHD in both groups of patients. This correlation was lost after adjusting for age and body mass index in patients with diabetes. These inpatients had higher serum P and lower uP/Cr, according to lower PTH. Their serum glucose negatively correlated with uCa/Cr and Ca ex, contrary to inpatients with other diseases. Instead, uCa/Cr and Ca ex correlated with uNa/Cr only in patients without diabetes. CONCLUSIONS Inpatients with diabetes did differ from those with other disorders for vitamin D status and calcium-phosphate homeostatic mechanism.
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Affiliation(s)
- V Carnevale
- Unit of Internal Medicine, Ospedale "Casa Sollievo della Sofferenza" IRCCS, San Giovanni Rotondo, FG, Italy.
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Nur H, Toraman NF, Arica Z, Sarier N, Samur A. The relationship between body composition and bone mineral density in postmenopausal Turkish women. Rheumatol Int 2012; 33:607-12. [PMID: 22481215 DOI: 10.1007/s00296-012-2391-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 03/11/2012] [Indexed: 10/28/2022]
Abstract
In a retrospective cross-sectional study among 202 postmenopausal women aged 46-75 years, we aimed to investigate the relationship between body composition and bone mineral density (BMD) to determine whether fat mass or lean mass is a better determinant of BMD in Turkish postmenopausal women. Lumbar spine (L1-L4) and proximal femur BMD were measured by dual energy X-ray absorbsiometry. Body composition analysis was performed by bioelectric impedance method and fat mass, lean mass, and percent fat were measured. Both fat mass and lean mass were positively correlated with BMD at the lumbar spine and proximal femur, weight and body mass index. Lean mass was also positively correlated with height and negatively correlated with age and years since menopause (P < 0.01). The correlations of fat mass and lean mass with BMD at the lumbar spine and proximal femur remained significant after adjustment for age, years since menopause and height. When the lean mass was adjusted together with age, years since menopause and height, the significant relationship between the fat mass and BMD continued, however the significant correlation between the lean mass and BMD disappeared at all sites after adjustment for fat mass. In multiple regression analyses, fat mass was the significant determinant of all BMD sites. Our data suggest that fat mass is the significant determinant of BMD at the lumbar spine and proximal femur, and lean mass does not have an impact on BMD when fat mass was taken into account in Turkish postmenopausal women.
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Affiliation(s)
- Hakan Nur
- Department of Physical Medicine and Rehabilitation, Antalya Education and Research Hospital, Antalya, Turkey.
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Basu R, Peterson J, Rizza R, Khosla S. Effects of physiological variations in circulating insulin levels on bone turnover in humans. J Clin Endocrinol Metab 2011; 96:1450-5. [PMID: 21325461 PMCID: PMC3085206 DOI: 10.1210/jc.2010-2877] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT Recent studies in mice have demonstrated that insulin signaling in osteoblasts stimulates bone formation and reduces osteoprotegerin production; the latter results in an increase in bone resorption, which then leads to the release of undercarboxylated osteocalcin from bone. Undercarboxylated osteocalcin, in turn, enhances insulin sensitivity. OBJECTIVE The objective of the study was to test whether physiological changes in insulin levels regulate bone metabolism in humans. DESIGN This investigation was an analysis of samples from a prospective study. SETTING The study was conducted at a clinical research unit. PARTICIPANTS AND INTERVENTIONS Fourteen subjects underwent a 7-h stepped insulin infusion accompanied by a glucose clamp and somatostatin infusion along with replacement infusions of GH and glucagon, thus isolating possible effects of insulin on bone. Insulin was infused at rates achieving low (∼150 pmol/liter), intermediate (∼350 pmol/liter), or high (∼700 pmol/liter) plasma insulin levels. MAIN OUTCOME MEASURES Bone turnover markers, undercarboxylated osteocalcin, and osteoprotegerin levels at the end of the low, intermediate, and high dose insulin infusions were measured. RESULTS Values for the outcome measures at the end of the intermediate- and high-dose insulin infusions were no different from values at the end of the low-dose insulin infusion. However, measures of insulin sensitivity (glucose infusion and disappearance rates) correlated positively with C-terminal telopeptide of type I collagen levels. CONCLUSIONS Acute changes in insulin levels, as occur during meals, do not regulate bone turnover, undercarboxylated osteocalcin, or osteoprotegerin levels. However, the correlation of measures of insulin sensitivity with bone resorption suggests the need for further studies in humans on the possible regulation of bone metabolism by insulin.
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Affiliation(s)
- Rita Basu
- Endocrine Research Unit, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
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Scott JPR, Sale C, Greeves JP, Casey A, Dutton J, Fraser WD. The role of exercise intensity in the bone metabolic response to an acute bout of weight-bearing exercise. J Appl Physiol (1985) 2010; 110:423-32. [PMID: 21127210 DOI: 10.1152/japplphysiol.00764.2010] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We compared the effects of exercise intensity (EI) on bone metabolism during and for 4 days after acute, weight-bearing endurance exercise. Ten males [mean ± SD maximum oxygen uptake (Vo(2max)): 56.2 ± 8.1 ml·min(-1)·kg(-1)] completed three counterbalanced 8-day trials. Following three control days, on day 4, subjects completed 60 min of running at 55%, 65%, and 75% Vo(2max). Markers of bone resorption [COOH-terminal telopeptide region of collagen type 1 (β-CTX)] and formation [NH(2)-terminal propeptides of procollagen type 1 (P1NP), osteocalcin (OC), bone-alkaline phosphatase (ALP)], osteoprotegerin (OPG), parathyroid hormone (PTH), albumin-adjusted calcium (ACa), phosphate (PO(4)), and cortisol were measured during and for 3 h after exercise and on four follow-up days (FU1-FU4). At 75% Vo(2max), β-CTX was not significantly increased from baseline by exercise but was higher compared with 55% (17-19%, P < 0.01) and 65% (11-13%, P < 0.05) Vo(2max) in the first hour postexercise. Concentrations were decreased from baseline in all three groups by 39-42% (P < 0.001) at 3 h postexercise but not thereafter. P1NP increased (P < 0.001) during exercise only, while bone-ALP was increased (P < 0.01) at FU3 and FU4, but neither were affected by EI. PTH and cortisol increased (P < 0.001) with exercise at 75% Vo(2max) only and were higher (P < 0.05) than at 55% and 65% Vo(2max) during and immediately after exercise. The increases (P < 0.001) in OPG, ACa, and PO(4) with exercise were not affected by EI. Increasing EI from 55% to 75% Vo(2max) during 60 min of running resulted in higher β-CTX concentrations in the first hour postexercise but had no effect on bone formation markers. Increased bone-ALP concentrations at 3 and 4 days postexercise suggest a beneficial effect of this type of exercise on bone mineralization. The increase in OPG was not influenced by exercise intensity, whereas PTH was increased at 75% Vo(2max) only, which cannot be fully explained by changes in serum calcium or PO(4) concentrations.
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Affiliation(s)
- Jonathan P R Scott
- QinetiQ, Rm. G077, Bldg. A54, Cody Technology Park, Ively Rd., Farnborough, Hampshire, UK GU14 0LX.
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Feeding and bone. Arch Biochem Biophys 2010; 503:11-9. [DOI: 10.1016/j.abb.2010.06.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/17/2010] [Accepted: 06/18/2010] [Indexed: 11/23/2022]
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Reid IR. Fat and bone. Arch Biochem Biophys 2010; 503:20-7. [DOI: 10.1016/j.abb.2010.06.027] [Citation(s) in RCA: 225] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 06/23/2010] [Accepted: 06/26/2010] [Indexed: 12/13/2022]
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Elnenaei MO, Musto R, Alaghband-Zadeh J, Moniz C, Le Roux CW. Postprandial bone turnover is independent of calories above 250 kcal. Ann Clin Biochem 2010; 47:318-20. [DOI: 10.1258/acb.2010.010010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The mechanisms causing bone turnover after food intake have not yet been elucidated. Several gut hormones are secreted in the postprandial phase, proportional to meal calorie content, and possibly one or more of these could influence bone turnover. The aim of this study was to investigate bone turnover in proportion to graded-calorie and fixed calcium containing meals. Methods A group of healthy volunteers were given six meals with calories varying from 250 to 3000 kcal on different occasions. All the meals contained 500 mg of calcium. C-telopeptide type I collagen (CTX) was measured before and 180 min after each meal. Results All meals significantly reduced CTX between 35.8 ± 5.6% and 44.8 ± 3.8%. No significant difference in CTX was however apparent for the different calorie containing meals. Observed differences suggest a trend to greater CTX suppression with lower protein and higher fat content of meals. Conclusion Changes in CTX are not proportional to calorie contents when the meals contain 500 mg of calcium. Further studies should now determine whether patients with increased bone resorption would benefit from multiple small meals to slow down the rate of bone loss.
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Affiliation(s)
- Manal O Elnenaei
- Clinical Biochemistry Department, King's College Hospital NHS Foundation Trust,London, SE5 9RS
| | - Rebecca Musto
- Clinical Biochemistry Department, King's College Hospital NHS Foundation Trust,London, SE5 9RS
| | - Jamshid Alaghband-Zadeh
- Clinical Biochemistry Department, King's College Hospital NHS Foundation Trust,London, SE5 9RS
| | - Caje Moniz
- Clinical Biochemistry Department, King's College Hospital NHS Foundation Trust,London, SE5 9RS
| | - Carel W Le Roux
- Clinical Biochemistry Department, King's College Hospital NHS Foundation Trust,London, SE5 9RS
- Department of Metabolic Medicine, Hammersmith Hospital, Imperial College London, London, WI2 0HS, UK
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Nuche-Berenguer B, Moreno P, Esbrit P, Dapía S, Caeiro JR, Cancelas J, Haro-Mora JJ, Villanueva-Peñacarrillo ML. Effect of GLP-1 treatment on bone turnover in normal, type 2 diabetic, and insulin-resistant states. Calcif Tissue Int 2009; 84:453-61. [PMID: 19219381 DOI: 10.1007/s00223-009-9220-3] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 01/14/2009] [Indexed: 10/21/2022]
Abstract
It has been suggested that hormones released after nutrient absorption, such as glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide 2 (GLP-2), could be responsible for changes in bone resorption. However, information about the role of GLP-1 in this regard is scanty. Diabetes-related bone loss occurs as a consequence of poor control of glucose homeostasis, but the relationship between osteoporosis and type 2 diabetes remains unclear. Since GLP-1 is decreased in the latter condition, we evaluated some bone characteristics in streptozotocin-induced type 2 diabetic (T2D) and fructose-induced insulin-resistant (IR) rat models compared to normal (N) and the effect of GLP-1 or saline (control) treatment (3 days by osmotic pump). Blood was taken before and after treatment for plasma measurements; tibiae and femora were collected for gene expression of bone markers (RT-PCR) and structure (microCT) analysis. Compared to N, plasma glucose and insulin were, respectively, higher and lower in T2D; osteocalcin (OC) and tartrate-resistant alkaline phosphatase 5b were lower; phosphate in IR showed a tendency to be higher; PTH was not different in T2D and IR; all parameters were unchanged after GLP-1 infusion. Bone OC, osteoprotegerin (OPG) and RANKL mRNA were lower in T2D and IR; GLP-1 increased OC and OPG in all groups and RANKL in T2D. Compared to N, trabecular bone parameters showed an increased degree of anisotropy in T2D and IR, which was reduced after GLP-1. These findings show an insulin-independent anabolic effect of GLP-1 and suggest that GLP-1 could be a useful therapeutic agent for improving the deficient bone formation and bone structure associated with glucose intolerance.
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Affiliation(s)
- Bernardo Nuche-Berenguer
- Department of Metabolism, Nutrition, and Hormones, Fundación Jiménez Díaz, Avda. Reyes Católicos 2, Madrid, Spain
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Vázquez Gámez MA, Marín Pérez JM, Montoya García MJ, Moruno García RM, Argüelles Martín F, Pérez Cano R. [Evolution of bone mass in children and adolescents with type 1 diabetes mellitus]. Med Clin (Barc) 2008; 130:526-30. [PMID: 18457618 DOI: 10.1157/13119714] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE There is some controversy over bone mineral density (BMD) in children and teenagers with type 1 diabetes mellitus (DM1). We evaluated BMD by dual-energy X-ray absorptiometry (DXA) and correlated it with anthropometric, biochemical and hormonal parameters related to bone metabolism. PATIENTS AND METHOD Sixty-six patients with DM1 (26 males and 40 females) aged between 3 and 17 years, and 327 controls with a similar age were studied. RESULTS The BMD of all diabetic patients was not different from that of the controls. However, the subgroup of older males (between 15 and 17 years) had a significantly inferior BMD than controls of the same age: mean (standard deviation), 0.888 (0.13) versus 0.994 (0.11) (p = 0.027). BMD was inferior to -1 standard deviation (Z-score) in 21.2% of diabetic children. All the biochemical and hormonal parameters were within the normality rank. There was a negative correlation between the evolution time of the disease and the levels of 25-hydroxycholecalciferol (r = -0.345; p = 0.006). We did not observe any correlation between BMD and the remaining studied parameters. CONCLUSIONS These results confirm that initially children and adolescents with non-complicated DM1 have no alteration of the bone mass. Yet the BMD physiological increase is smaller in the diabetic population than in controls during the adolescence period, which may cause a lower peak of bone mass in these patients.
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Abstract
Body weight impacts both bone turnover and bone density, making it, therefore, an important risk factor for vertebral and hip fractures and ranking it alongside age in importance. The effect of body weight is probably contributed to by both fat mass and lean mass, though in postmenopausal women, fat mass has been more consistently demonstrated to be important. A number of mechanisms for the fat-bone relationship exist and include the effect of soft tissue mass on skeletal loading, the association of fat mass with the secretion of bone active hormones from the pancreatic beta cell (including insulin, amylin, and preptin), and the secretion of bone active hormones (e.g., estrogens and leptin) from the adipocyte. These factors alone probably do not fully explain the observed clinical associations, and study of the actions on bone of novel hormones related to nutrition is an important area of further research. An understanding of this aspect of bone biology may open the way for new treatments of osteoporosis. More immediately, the role of weight maintenance in the prevention of osteoporosis is an important public health message that needs to be more widely appreciated.
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Affiliation(s)
- I R Reid
- University of Auckland, Auckland, New Zealand.
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Abstract
Bone Markers - Their Nature and Clinical UseBone remodeling units are the centerpiece of bone metabolism. They are fueled by a synchronized and well balanced interaction of osteoclasts and osteoblasts, the activity of which releases specific substances known as bone markers into the blood. Resorption markers result from osteoclastic activity, formation markers from osteoblastic activity, and turnover markers from both cell types. In clinical practice, bone markers are today widely used for monitoring of antiresorptive therapy and patient compliance. There is strong evidence that they are also useful for risk assessment with respect to osteoporosis, here complementing established imaging methods. Other possible and partly not yet investigated indications include monitoring of side-effects of certain therapeutic drugs and oncology. In particular the combination of resorption and formation markers may open up a more differentiated insight into the metabolic situation of a patient's bone. The activity of osteoclasts and osteoblasts is triggered and modulated by numerous factors, some of which are of endocrine nature. Easily measurable in today's laboratory are for instance PTH, calcitonin and vitamin D. While calcitonin is not widely used in osteology, PTH and vitamin D define risk factors for an accelerated loss of bone and impaired mineralization of osteoid with the related diseases of osteoporosis, ricketts and osteomalacia. Recent developments in lab diagnosis of bone diseases focus on rheumatic diseases like rheumatoid arthritis, where anti-CCP is a much more specific marker than the common rheuma factors.
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Sultan E, Taha I, Saber LM. Altered Bone Metabolic Markers In Type 2 Diabetes Mellitus: Impact of Glycemic Control. J Taibah Univ Med Sci 2008. [DOI: 10.1016/s1658-3612(08)70059-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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