Reduction in bone resorption by exogenous glucagon-like peptide-2 administration requires an intact gastrointestinal tract.

Abstract

OBJECTIVE:

Biochemical markers for bone resorption (s-CTX) are reduced by food intake, whereas markers for bone formation seem to be unaffected by meal status. Glucagon-like peptide-2 (GLP-2) is a peptide secreted from endocrine L cells in the intestinal mucosa in relation to food-intake. Subcutaneous GLP-2 treatment has been shown to reduce bone resorption in postmenopausal women. The objective of this study was to investigate the ability of exogenous GLP-2 to reduce bone resorption in patients with jejunostomy or ileostomy and to elucidate whether an intact gastrointestinal tract and the ability to secrete GLP-2 are required for meal-induced inhibition of bone resorption.

MATERIAL AND METHODS:

Fifteen control subjects, 13 colectomized patients with an ileostomy and 12 colectomized patients with a jejunostomy (remnant small bowel 89 +/- 53 cm) were given: a) a subcutaneous injection of 1600 microg GLP-2, b) placebo and c) 3.8 MJ of a breakfast meal. Blood was sampled for measurements of s-CTX, s-osteocalcin and GLP-2 for 4 h after each intervention.

RESULTS:

After the GLP-2 injection, only control subjects showed a significant reduction in s-CTX (24% +/- 13%, p = 0.05, 120 min) compared with baseline values. Patients with an ileostomy had a preserved endogenous postprandial GLP-2 secretion, which was absent in patients with a jejunostomy. Consumption of a meal reduced s-CTX in all groups but significantly less so in the jejunostomy group.

CONCLUSIONS:

Reductions in bone resorption by exogenous GLP-2 require an intact gastrointestinal tract. The decreased meal-induced inhibition of bone resorption in the jejunostomy patients, who lack a GLP-2 response, supports the view that GLP-2 plays a role in postprandial reduction in bone resorption.

• Authors: Ida B Gottschalck, Palle B Jeppesen, Jens J Holst, Dennis B Henriksen
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 43 Issue 8 Pg. 929-37 (Aug 2008) ISSN: 0036-5521 [Print] England
• PMID: 19086164 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers
• Collagen Type I
• Glucagon-Like Peptide 2

Topics

• Biomarkers (blood)
• Bone Resorption (blood, drug therapy, etiology)
• Colectomy (adverse effects)
• Collagen Type I (blood)
• Enzyme-Linked Immunosorbent Assay
• Female
• Follow-Up Studies
• Glucagon-Like Peptide 2 (administration & dosage, pharmacokinetics)
• Humans
• Ileostomy (adverse effects)
• Injections, Subcutaneous
• Male
• Middle Aged
• Radioimmunoassay
• Retrospective Studies
• Short Bowel Syndrome (blood, complications, drug therapy)
• Treatment Outcome