Short-term administration of glucagon-like peptide-2. Effects on bone mineral density and markers of bone turnover in short-bowel patients with no colon

KV Haderslev, PB Jeppesen, B Hartmann… - Scandinavian journal …, 2002 - Taylor & Francis
KV Haderslev, PB Jeppesen, B Hartmann, J Thulesen, HA Sorensen, J Graff, BS Hansen…
Scandinavian journal of gastroenterology, 2002Taylor & Francis
Background: Glucagon-like peptide 2 (GLP-2) is a newly discovered intestinotrophic
hormone. We have recently reported that a 5-week GLP-2 treatment improved the intestinal
absorptive capacity of shortbowel patients with no colon. Additionally, GLP-2 treatment was
associated with changes in body composition that included a significant increase in total
body bone mass. This article describes the effect of GLP-2 on spinal and hip bone mineral
density (BMD) and biochemical markers of bone turnover in these patients. Methods: In an …
Background
Glucagon-like peptide 2 (GLP-2) is a newly discovered intestinotrophic hormone. We have recently reported that a 5-week GLP-2 treatment improved the intestinal absorptive capacity of shortbowel patients with no colon. Additionally, GLP-2 treatment was associated with changes in body composition that included a significant increase in total body bone mass. This article describes the effect of GLP-2 on spinal and hip bone mineral density (BMD) and biochemical markers of bone turnover in these patients.
Methods
In an open-labelled pilot study, eight short-bowel patients (3M, 5F; mean age 49 years) with small-bowel resection and no colon received 400 μg s.c. of GLP-2 twice daily for 5 weeks. Four received home parenteral nutrition (mean length of residual jejunum 83 cm) and 4 did not (mean length of ileum resected 106 cm). The outcome measures were the mean percent change from baseline in spinal and hip BMD measured by dual-energy X-ray absorptiometry, changes in four biochemical markers of bone-turnover, PTH, 25-hydroxy vitamin-D, and the intestinal absorption of calcium.
Results
Mean ± s x (SEM) percent changes in spinal and hip BMD were 1.1 ± 0.4% ( P < 0.05) and 1.9 ± 0.8% ( P = 0.06), respectively. The intestinal calcium absorption increased by 2.7% ( P = 0.87). Serum ionized calcium increased in 5/8 patients with a concomitant decrease in serum PTH values. Three of the four markers of bone turnover decreased.
Conclusion
A 5-week GLP-2 administration significantly increased spinal BMD in short-bowel patients with no colon. The mechanism by which GLP-2 affects bone metabolism remains unclear, but may be related to an increased mineralization of bone resulting from an improved intestinal calcium absorption.
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