Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome

Ida B Gottschalck; Palle B Jeppesen; Bolette Hartmann; Jens Juul Holst; Dennis B Henriksen

doi:10.1080/00365520802200028

Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome

Ida B Gottschalck, Palle B Jeppesen, Bolette Hartmann, Jens Juul Holst, Dennis B Henriksen

31 Citations (Scopus)

Abstract

OBJECTIVE: The gut hormone GLP-2 (glucagon-like peptide-2) seems to be involved in the circadian pattern of bone resorption, whereas parathyroid hormone (PTH) is an established key hormone in bone turnover. Endogenous GLP-2 secretion is lacking in colectomized patients with short-bowel syndrome (SBS) and they have reduced bone mineral density (BMD). The aim of the study was to investigate the anti-resorptive effect (assessed by s-CTX) of 14 days of GLP-2 treatment in these patients and to determine whether 56 days of treatment would improve BMD. PTH secretion in response to GLP-2 was also investigated in colectomized SBS patients and colectomized controls (with ileostomy).

MATERIAL AND METHODS: Eight SBS patients and 13 patients with ileostomy were treated with subcutaneous injections of 1600 microg GLP-2 at bedtime for 56 and 14 consecutive days, respectively. BMD was determined at days 1 and 56 in SBS patients. On days 1 and 14, measurements of CTX, P1NP and PTH were taken 4 h after the GLP-2 injection.

RESULTS: Patients with ileostomy showed a significant reduction in bone resorption after GLP-2 injections at days 1 and 14. In contrast, there was no change in s-CTX after 1 and 14 days in the SBS patients, and after 56 days of GLP-2 treatment there was no improvement in BMD. A significant reduction in PTH secretion in response to GLP-2 was observed only in patients with ileostomy.

CONCLUSIONS: The decreased bone resorption in response to GLP-2 injections cannot be elicited in SBS patients and therefore precludes treatment of their osteopenia with GLP-2. The anti-resorptive response to GLP-2 seems to require an intact small intestine and may involve suppression of PTH secretion.

Original language	English
Journal	Scandinavian Journal of Gastroenterology
Volume	43
Issue number	11
Pages (from-to)	1304-10
Number of pages	7
ISSN	0036-5521
DOIs	https://doi.org/10.1080/00365520802200028
Publication status	Published - 2008

Keywords

Adult
Body Mass Index
Bone Density
Bone Density Conservation Agents
Bone Resorption
Circadian Rhythm
Colectomy
Female
Glucagon-Like Peptide 2
Humans
Ileostomy
Injections, Subcutaneous
Jejunostomy
Male
Middle Aged
Parathyroid Hormone
Short Bowel Syndrome
Treatment Outcome

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10.1080/00365520802200028

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Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome. / Gottschalck, Ida B; Jeppesen, Palle B ; Hartmann, Bolette et al.
In: Scandinavian Journal of Gastroenterology, Vol. 43, No. 11, 2008, p. 1304-10.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome",

abstract = "OBJECTIVE: The gut hormone GLP-2 (glucagon-like peptide-2) seems to be involved in the circadian pattern of bone resorption, whereas parathyroid hormone (PTH) is an established key hormone in bone turnover. Endogenous GLP-2 secretion is lacking in colectomized patients with short-bowel syndrome (SBS) and they have reduced bone mineral density (BMD). The aim of the study was to investigate the anti-resorptive effect (assessed by s-CTX) of 14 days of GLP-2 treatment in these patients and to determine whether 56 days of treatment would improve BMD. PTH secretion in response to GLP-2 was also investigated in colectomized SBS patients and colectomized controls (with ileostomy).MATERIAL AND METHODS: Eight SBS patients and 13 patients with ileostomy were treated with subcutaneous injections of 1600 microg GLP-2 at bedtime for 56 and 14 consecutive days, respectively. BMD was determined at days 1 and 56 in SBS patients. On days 1 and 14, measurements of CTX, P1NP and PTH were taken 4 h after the GLP-2 injection.RESULTS: Patients with ileostomy showed a significant reduction in bone resorption after GLP-2 injections at days 1 and 14. In contrast, there was no change in s-CTX after 1 and 14 days in the SBS patients, and after 56 days of GLP-2 treatment there was no improvement in BMD. A significant reduction in PTH secretion in response to GLP-2 was observed only in patients with ileostomy.CONCLUSIONS: The decreased bone resorption in response to GLP-2 injections cannot be elicited in SBS patients and therefore precludes treatment of their osteopenia with GLP-2. The anti-resorptive response to GLP-2 seems to require an intact small intestine and may involve suppression of PTH secretion.",

keywords = "Adult, Body Mass Index, Bone Density, Bone Density Conservation Agents, Bone Resorption, Circadian Rhythm, Colectomy, Female, Glucagon-Like Peptide 2, Humans, Ileostomy, Injections, Subcutaneous, Jejunostomy, Male, Middle Aged, Parathyroid Hormone, Short Bowel Syndrome, Treatment Outcome",

author = "Gottschalck, {Ida B} and Jeppesen, {Palle B} and Bolette Hartmann and Holst, {Jens Juul} and Henriksen, {Dennis B}",

year = "2008",

doi = "10.1080/00365520802200028",

language = "English",

volume = "43",

pages = "1304--10",

journal = "Scandinavian Journal of Gastroenterology",

issn = "0036-5521",

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TY - JOUR

T1 - Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome

AU - Gottschalck, Ida B

AU - Jeppesen, Palle B

AU - Hartmann, Bolette

AU - Holst, Jens Juul

AU - Henriksen, Dennis B

PY - 2008

Y1 - 2008

N2 - OBJECTIVE: The gut hormone GLP-2 (glucagon-like peptide-2) seems to be involved in the circadian pattern of bone resorption, whereas parathyroid hormone (PTH) is an established key hormone in bone turnover. Endogenous GLP-2 secretion is lacking in colectomized patients with short-bowel syndrome (SBS) and they have reduced bone mineral density (BMD). The aim of the study was to investigate the anti-resorptive effect (assessed by s-CTX) of 14 days of GLP-2 treatment in these patients and to determine whether 56 days of treatment would improve BMD. PTH secretion in response to GLP-2 was also investigated in colectomized SBS patients and colectomized controls (with ileostomy).MATERIAL AND METHODS: Eight SBS patients and 13 patients with ileostomy were treated with subcutaneous injections of 1600 microg GLP-2 at bedtime for 56 and 14 consecutive days, respectively. BMD was determined at days 1 and 56 in SBS patients. On days 1 and 14, measurements of CTX, P1NP and PTH were taken 4 h after the GLP-2 injection.RESULTS: Patients with ileostomy showed a significant reduction in bone resorption after GLP-2 injections at days 1 and 14. In contrast, there was no change in s-CTX after 1 and 14 days in the SBS patients, and after 56 days of GLP-2 treatment there was no improvement in BMD. A significant reduction in PTH secretion in response to GLP-2 was observed only in patients with ileostomy.CONCLUSIONS: The decreased bone resorption in response to GLP-2 injections cannot be elicited in SBS patients and therefore precludes treatment of their osteopenia with GLP-2. The anti-resorptive response to GLP-2 seems to require an intact small intestine and may involve suppression of PTH secretion.

AB - OBJECTIVE: The gut hormone GLP-2 (glucagon-like peptide-2) seems to be involved in the circadian pattern of bone resorption, whereas parathyroid hormone (PTH) is an established key hormone in bone turnover. Endogenous GLP-2 secretion is lacking in colectomized patients with short-bowel syndrome (SBS) and they have reduced bone mineral density (BMD). The aim of the study was to investigate the anti-resorptive effect (assessed by s-CTX) of 14 days of GLP-2 treatment in these patients and to determine whether 56 days of treatment would improve BMD. PTH secretion in response to GLP-2 was also investigated in colectomized SBS patients and colectomized controls (with ileostomy).MATERIAL AND METHODS: Eight SBS patients and 13 patients with ileostomy were treated with subcutaneous injections of 1600 microg GLP-2 at bedtime for 56 and 14 consecutive days, respectively. BMD was determined at days 1 and 56 in SBS patients. On days 1 and 14, measurements of CTX, P1NP and PTH were taken 4 h after the GLP-2 injection.RESULTS: Patients with ileostomy showed a significant reduction in bone resorption after GLP-2 injections at days 1 and 14. In contrast, there was no change in s-CTX after 1 and 14 days in the SBS patients, and after 56 days of GLP-2 treatment there was no improvement in BMD. A significant reduction in PTH secretion in response to GLP-2 was observed only in patients with ileostomy.CONCLUSIONS: The decreased bone resorption in response to GLP-2 injections cannot be elicited in SBS patients and therefore precludes treatment of their osteopenia with GLP-2. The anti-resorptive response to GLP-2 seems to require an intact small intestine and may involve suppression of PTH secretion.

KW - Adult

KW - Body Mass Index

KW - Bone Density

KW - Bone Density Conservation Agents

KW - Bone Resorption

KW - Circadian Rhythm

KW - Colectomy

KW - Female

KW - Glucagon-Like Peptide 2

KW - Humans

KW - Ileostomy

KW - Injections, Subcutaneous

KW - Jejunostomy

KW - Male

KW - Middle Aged

KW - Parathyroid Hormone

KW - Short Bowel Syndrome

KW - Treatment Outcome

U2 - 10.1080/00365520802200028

DO - 10.1080/00365520802200028

M3 - Journal article

C2 - 18609184

SN - 0036-5521

VL - 43

SP - 1304

EP - 1310

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

IS - 11

ER -

Effects of treatment with glucagon-like peptide-2 on bone resorption in colectomized patients with distal ileostomy or jejunostomy and short-bowel syndrome

Abstract

Keywords

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