The Gut-Bone Axis in Diabetes.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Current Osteoporosis Reports Pub Date : 2023-02-01 DOI:10.1007/s11914-022-00767-2

Henrik Maagensen, Mads M Helsted, Lærke S Gasbjerg, Tina Vilsbøll, Filip K Knop

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引用次数: 2

Abstract

Purpose of review: To describe recent advances in the understanding of how gut-derived hormones regulate bone homeostasis in humans with emphasis on pathophysiological and therapeutic perspectives in diabetes.

Recent findings: The gut-derived incretin hormone glucose-dependent insulinotropic polypeptide (GIP) is important for postprandial suppression of bone resorption. The other incretin hormone, glucagon-like peptide 1 (GLP-1), as well as the intestinotrophic glucagon-like peptide 2 (GLP-2) has been shown to suppress bone resorption in pharmacological concentrations, but the role of the endogenous hormones in bone homeostasis is uncertain. For ambiguous reasons, both patients with type 1 and type 2 diabetes have increased fracture risk. In diabetes, the suppressive effect of endogenous GIP on bone resorption seems preserved, while the effect of GLP-2 remains unexplored both pharmacologically and physiologically. GLP-1 receptor agonists, used for the treatment of type 2 diabetes and obesity, may reduce bone loss, but results are inconsistent. GIP is an important physiological suppressor of postprandial bone resorption, while GLP-1 and GLP-2 may also exert bone-preserving effects when used pharmacologically. A better understanding of the actions of these gut hormones on bone homeostasis in patients with diabetes may lead to new strategies for the prevention and treatment of skeletal frailty related to diabetes.

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糖尿病的肠-骨轴。

综述的目的:从糖尿病的病理生理和治疗角度，描述肠道源性激素如何调节人类骨骼稳态的最新进展。最近发现:肠源性肠促胰岛素激素葡萄糖依赖性胰岛素多肽(GIP)对餐后骨吸收抑制很重要。另一种肠促胰岛素激素，胰高血糖素样肽1 (GLP-1)，以及肠营养胰高血糖素样肽2 (GLP-2)已被证明在药理学浓度下抑制骨吸收，但内源性激素在骨稳态中的作用尚不确定。由于不明确的原因，1型和2型糖尿病患者骨折风险增加。在糖尿病中，内源性GIP对骨吸收的抑制作用似乎得到了保留，而GLP-2的作用在药理学和生理学上都尚未得到探索。GLP-1受体激动剂，用于治疗2型糖尿病和肥胖，可能减少骨质流失，但结果不一致。GIP是餐后骨吸收的重要生理性抑制因子，而GLP-1和GLP-2在药理学上也可能发挥保骨作用。更好地了解这些肠道激素对糖尿病患者骨骼稳态的作用，可能会为预防和治疗糖尿病相关的骨骼脆弱提供新的策略。

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来源期刊

Current Osteoporosis Reports Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

8.80

自引率

2.30%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.