健康成人摄入葡萄糖后的骨吸收和肠促生长素

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical and Translational Endocrinology Pub Date : 2023-03-01 DOI:10.1016/j.jcte.2023.100314

Wang Shin Lei , Eugene B. Rodrick , Staci L. Belcher , Andrea Kelly , Joseph M. Kindler

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引用次数: 0

摘要

背景对成人的研究表明，摄入大量营养素会对骨骼产生急性抗吸收作用，这反映在骨吸收的生物标志物C末端末端肽（CTX）的减少上，而肠道来源的肠促胰岛素激素、葡萄糖依赖性促胰岛素多肽（GIP）和胰高血糖素样肽-1（GLP-1）促进了这种反应。关于骨转换的其他生物标志物，以及在骨强度达到峰值的几年内，肠骨串扰是否有效，仍存在知识空白。本研究首先描述了口服葡萄糖耐量试验（OGTT）期间骨吸收的变化，其次测试了OGTT期间肠促胰岛素和骨生物标志物的变化与骨微观结构之间的关系。方法我们对10名18-25岁的健康成年人进行了横断面研究。在多样本2小时75 g OGTT过程中，在第0、30、60和120分钟测定葡萄糖、胰岛素、GIP、GLP-1、CTX、骨特异性碱性磷酸酶（BSAP）、骨钙素、骨保护素（OPG）、核因子-κ-β配体受体激活剂（RANKL）、硬化素和甲状旁腺激素（PTH）。曲线下的增量面积（iAUC）从0–30分钟和0–120分钟开始计算。使用第二代高分辨率外围定量计算机断层扫描评估胫骨微结构。结果OGTT期间，血糖、胰岛素、GIP和GLP-1显著升高。第30、60和120分钟的CTX显著低于第0分钟，到第120分钟时最大下降约53%。葡萄糖-iAUC0-30与CTX-iAUC0-120呈负相关（rho=0.91，P<；0.001），GLP-1-iAUC0-30与BSAP-iAUC0-120呈正相关（rho=0.83，P=0.005），RANKL-iAUC0-120（rho=0.86，P=0.007），和皮质体积骨密度（rho=0.93，P<；0.001）。结论在骨强度峰值周围的几年里，摄入葡萄糖对骨代谢产生抗吸收作用。在这个关键的生命阶段，肠道和骨骼之间的串扰需要进一步关注。

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Bone resorption and incretin hormones following glucose ingestion in healthy emerging adults

Background

Studies in adults indicate that macronutrient ingestion yields an acute anti-resorptive effect on bone, reflected by decreases in C-terminal telopeptide (CTX), a biomarker of bone resorption, and that gut-derived incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), facilitate this response. There remain knowledge gaps relating to other biomarkers of bone turnover, and whether gut-bone cross-talk is operative during the years surrounding peak bone strength attainment. This study first, describes changes in bone resorption during oral glucose tolerance testing (OGTT), and second, tests relationships between changes in incretins and bone biomarkers during OGTT and bone micro-structure.

Methods

We conducted a cross-sectional study in 10 healthy emerging adults ages 18–25 years. During a multi-sample 2-hour 75 g OGTT, glucose, insulin, GIP, GLP-1, CTX, bone-specific alkaline phosphatase (BSAP), osteocalcin, osteoprotegerin (OPG), receptor activator of nuclear factor kappa-β ligand (RANKL), sclerostin, and parathyroid hormone (PTH) were assayed at mins 0, 30, 60, and 120. Incremental areas under the curve (iAUC) were computed from mins 0–30 and mins 0–120. Tibia bone micro-structure was assessed using second generation high resolution peripheral quantitative computed tomography.

Results

During OGTT, glucose, insulin, GIP, and GLP-1 increased significantly. CTX at min 30, 60, and 120 was significantly lower than min 0, with a maximum decrease of about 53 % by min 120. Glucose-iAUC_0-30 inversely correlated with CTX-iAUC_0-120 (rho = -0.91, P < 0.001), and GLP-1-iAUC_0-30 positively correlated with BSAP-iAUC_0-120 (rho = 0.83, P = 0.005), RANKL-iAUC_0-120 (rho = 0.86, P = 0.007), and cortical volumetric bone mineral density (rho = 0.93, P < 0.001).

Conclusions

Glucose ingestion yields an anti-resorptive effect on bone metabolism during the years surrounding peak bone strength. Cross-talk between the gut and bone during this pivotal life stage requires further attention.

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