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Bone metabolism and incretin hormones following glucose ingestion in young adults with pancreatic insufficient cystic fibrosis. | LitMetric

AI Article Synopsis

  • The study investigates how gut hormones GIP and GLP-1 affect bone metabolism in individuals with cystic fibrosis (CF) and pancreatic insufficiency, particularly during oral glucose tolerance tests (OGTT).
  • Results showed a significant decrease in a bone resorption marker (CTX) during OGTT, linked to changes in GIP levels, while the bone formation marker (P1NP) remained unchanged.
  • The findings suggest that GIP plays a crucial role in the bone response to glucose ingestion in CF, indicating a need for more research on the "gut-bone axis" in relation to diabetes and bone health in these patients.

Article Abstract

Background: Gut-derived incretin hormones, including glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide 1 (GLP-1), regulate post-prandial glucose metabolism by promoting insulin production. GIP, GLP-1, and insulin contribute to the acute bone anti-resorptive effect of macronutrient ingestion by modifying bone turnover. Cystic fibrosis (CF) is associated with exocrine pancreatic insufficiency (PI), which perturbs the incretin response. Cross-talk between the gut and bone ("gut-bone axis") has not yet been studied in PI-CF. The objectives of this study were to assess changes in biomarkers of bone metabolism during oral glucose tolerance testing (OGTT) and to test associations between incretins and biomarkers of bone metabolism in individuals with PI-CF.

Methods: We performed a secondary analysis of previously acquired blood specimens from multi-sample OGTT from individuals with PI-CF ages 14-30 years (n = 23). Changes in insulin, incretins, and biomarkers of bone resorption (C-terminal telopeptide of type 1 collagen [CTX]) and formation (procollagen type I -terminal propeptide [P1NP]) during OGTT were computed.

Results: CTX decreased by 32% by min 120 of OGTT (P < 0.001), but P1NP was unchanged. Increases in GIP from 0 to 30 mins (rho = -0.48, P = 0.03) and decreases in GIP from 30 to 120 mins (rho = 0.62, P = 0.002) correlated with decreases in CTX from mins 0-120. Changes in GLP-1 and insulin were not correlated with changes in CTX, and changes in incretins and insulin were not correlated with changes in P1NP.

Conclusions: Intact GIP response was correlated with the bone anti-resorptive effect of glucose ingestion, represented by a decrease in CTX. Since incretin hormones might contribute to development of diabetes and bone disease in CF, the "gut-bone axis" warrants further attention in CF during the years surrounding peak bone mass attainment.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467887PMC
http://dx.doi.org/10.1016/j.jcte.2022.100304DOI Listing

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