Bone resorption is decreased postprandially by intestinal factors and glucagon-like peptide-2 is a possible candidate.
OBJECTIVE
Food intake inhibits bone resorption by a mechanism thought to involve gut hormones, and the intestinotrophic glucagon-like peptide 2 (GLP-2) is a candidate because exogenous GLP-2 inhibits bone resorption in humans. The purpose of the study was to investigate patients with short-bowel syndrome (SBS) or total gastrectomy in order to elucidate whether the signal for the meal-induced reduction of bone resorption is initiated from the stomach or the intestine.


METHODS
Bone resorption was assessed from the serum concentration of collagen type I C-telopeptide cross-links (s-CTX) and compared with the plasma concentrations of GLP-2. Bone formation was assessed from serum osteocalcin concentrations. Seven SBS patients with a preserved colon and 7 with SBS and colectomy and 7 healthy controls were given a breakfast test meal (936 kcal). Eight patients who had undergone total gastrectomy had an oral glucose load (75 g in 150 ml).


RESULTS
The SBS patients without a colon showed no reduction in bone resorption (s-CTX) to a meal, whereas SBS patients with a colon had an intermediate response with a 27% (p<0.05) reduction of s-CTX from baseline after 120 min as compared with 66% (p<0.001) for normal controls. A significant reduction of 53% (p<0.001) was seen in gastrectomized patients after receiving oral glucose, which is comparable with the published data for the oral glucose tolerance test (OGGT) in healthy subjects (50% reduction over 120 min). Bone formation was unchanged for both SBS and gastrectomy patients. GLP-2 concentrations increased significantly in all groups with the exception of the SBS plus colectomy group.


CONCLUSIONS
An intestinal factor is responsible for the postprandial reduction in bone resorption, and our findings are compatible with such a function for GLP-2.
Holst
Jens J
JJ
Department of Medical Physiology, the Panum Institute, University of Copenhagen, Denmark. holst@mfi.ku.dk
Hartmann
Bolette
B
Gottschalck
Ida B
IB
Jeppesen
Palle B
PB
Miholic
Johannes
J
Henriksen
Dennis Bang
DB
D000328:Adult; D000368:Aged; D001862:Bone Resorption / Q000503:physiopathology*; D003082:Colectomy; D024042:Collagen Type I / Q000097:blood; D005743:Gastrectomy; D041981:Gastrointestinal Tract / Q000502:physiology*; D053767:Glucagon-Like Peptide 2 / Q000097:blood / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010012:Osteogenesis / Q000502:physiology; D010455:Peptides / Q000097:blood; D019518:Postprandial Period / Q000502:physiology; D012778:Short Bowel Syndrome / Q000503:physiopathology*
D024042:Collagen Type I; D053767:Glucagon-Like Peptide 2; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin