Bone Turnover Markers in Patients with Nonalcoholic Fatty Liver Disease and/or Type 2 Diabetes during Oral Glucose and Isoglycemic Intravenous Glucose

Henrik Maagensen, Anders E. Junker, Niklas R. Jørgensen, Lise L. Gluud, Filip K. Knop, Tina Vilsbøll*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Context: Nonalcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes (T2D) and vice versa, and both conditions are associated with an increased risk of fractures and altered bone turnover. Although patients with NAFLD typically suffer from decreased bone mineral density (BMD), T2D is associated with normal to high BMD. The pathophysiology is uncertain but may involve the gut-bone axis. Objective: We investigated the influence of the gut on glucose-induced changes in plasma bone turnover markers in healthy controls and patients with T2D and/or biopsy-verified NAFLD. Design: Cross-sectional cohort study. Patients: Patients with NAFLD with normal glucose tolerance, patients with NAFLD and T2D, patients with T2D without liver disease, and healthy controls. Interventions: Four-hour 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). Main Outcome Measures: Collagen type 1 C-telopeptide (CTX), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone. Results: Plasma glucose levels achieved during OGTTs were successfully matched on corresponding IIGI days. Patients with NAFLD and T2D exhibited similar CTX suppression during the two glucose challenges (P = 0.46) and pronounced suppression of P1NP during IIGI compared with OGTT. Conversely, remaining groups showed greater (P < 0.05) CTX suppression during OGTT and similar suppression of bone formation markers during IIGI and OGTT. Conclusions: OGTT-induced CTX suppression seems to be impaired in patients with NAFLD and T2D, but preserved in patients with either NAFLD or T2D, suggesting that coexistence of T2D and NAFLD may affect gut-bone axis.

OriginalsprogEngelsk
TidsskriftJournal of Clinical Endocrinology and Metabolism
Vol/bind103
Udgave nummer5
Sider (fra-til)2042-2049
ISSN0021-972X
DOI
StatusUdgivet - 1. maj 2018

Fingeraftryk

Type 2 Diabetes Mellitus
Glucose Tolerance Test
Intravenous Infusions
Collagen Type I
Bone Density
Osteocalcin
Parathyroid Hormone
Osteogenesis
Liver Diseases
Cohort Studies
Cross-Sectional Studies
Outcome Assessment (Health Care)

Citer dette

Maagensen, Henrik ; Junker, Anders E. ; Jørgensen, Niklas R. ; Gluud, Lise L. ; Knop, Filip K. ; Vilsbøll, Tina. / Bone Turnover Markers in Patients with Nonalcoholic Fatty Liver Disease and/or Type 2 Diabetes during Oral Glucose and Isoglycemic Intravenous Glucose. I: Journal of Clinical Endocrinology and Metabolism. 2018 ; Bind 103, Nr. 5. s. 2042-2049.
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abstract = "Context: Nonalcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes (T2D) and vice versa, and both conditions are associated with an increased risk of fractures and altered bone turnover. Although patients with NAFLD typically suffer from decreased bone mineral density (BMD), T2D is associated with normal to high BMD. The pathophysiology is uncertain but may involve the gut-bone axis. Objective: We investigated the influence of the gut on glucose-induced changes in plasma bone turnover markers in healthy controls and patients with T2D and/or biopsy-verified NAFLD. Design: Cross-sectional cohort study. Patients: Patients with NAFLD with normal glucose tolerance, patients with NAFLD and T2D, patients with T2D without liver disease, and healthy controls. Interventions: Four-hour 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). Main Outcome Measures: Collagen type 1 C-telopeptide (CTX), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone. Results: Plasma glucose levels achieved during OGTTs were successfully matched on corresponding IIGI days. Patients with NAFLD and T2D exhibited similar CTX suppression during the two glucose challenges (P = 0.46) and pronounced suppression of P1NP during IIGI compared with OGTT. Conversely, remaining groups showed greater (P < 0.05) CTX suppression during OGTT and similar suppression of bone formation markers during IIGI and OGTT. Conclusions: OGTT-induced CTX suppression seems to be impaired in patients with NAFLD and T2D, but preserved in patients with either NAFLD or T2D, suggesting that coexistence of T2D and NAFLD may affect gut-bone axis.",
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Bone Turnover Markers in Patients with Nonalcoholic Fatty Liver Disease and/or Type 2 Diabetes during Oral Glucose and Isoglycemic Intravenous Glucose. / Maagensen, Henrik; Junker, Anders E.; Jørgensen, Niklas R.; Gluud, Lise L.; Knop, Filip K.; Vilsbøll, Tina.

I: Journal of Clinical Endocrinology and Metabolism, Bind 103, Nr. 5, 01.05.2018, s. 2042-2049.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Bone Turnover Markers in Patients with Nonalcoholic Fatty Liver Disease and/or Type 2 Diabetes during Oral Glucose and Isoglycemic Intravenous Glucose

AU - Maagensen, Henrik

AU - Junker, Anders E.

AU - Jørgensen, Niklas R.

AU - Gluud, Lise L.

AU - Knop, Filip K.

AU - Vilsbøll, Tina

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Context: Nonalcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes (T2D) and vice versa, and both conditions are associated with an increased risk of fractures and altered bone turnover. Although patients with NAFLD typically suffer from decreased bone mineral density (BMD), T2D is associated with normal to high BMD. The pathophysiology is uncertain but may involve the gut-bone axis. Objective: We investigated the influence of the gut on glucose-induced changes in plasma bone turnover markers in healthy controls and patients with T2D and/or biopsy-verified NAFLD. Design: Cross-sectional cohort study. Patients: Patients with NAFLD with normal glucose tolerance, patients with NAFLD and T2D, patients with T2D without liver disease, and healthy controls. Interventions: Four-hour 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). Main Outcome Measures: Collagen type 1 C-telopeptide (CTX), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone. Results: Plasma glucose levels achieved during OGTTs were successfully matched on corresponding IIGI days. Patients with NAFLD and T2D exhibited similar CTX suppression during the two glucose challenges (P = 0.46) and pronounced suppression of P1NP during IIGI compared with OGTT. Conversely, remaining groups showed greater (P < 0.05) CTX suppression during OGTT and similar suppression of bone formation markers during IIGI and OGTT. Conclusions: OGTT-induced CTX suppression seems to be impaired in patients with NAFLD and T2D, but preserved in patients with either NAFLD or T2D, suggesting that coexistence of T2D and NAFLD may affect gut-bone axis.

AB - Context: Nonalcoholic fatty liver disease (NAFLD) is associated with type 2 diabetes (T2D) and vice versa, and both conditions are associated with an increased risk of fractures and altered bone turnover. Although patients with NAFLD typically suffer from decreased bone mineral density (BMD), T2D is associated with normal to high BMD. The pathophysiology is uncertain but may involve the gut-bone axis. Objective: We investigated the influence of the gut on glucose-induced changes in plasma bone turnover markers in healthy controls and patients with T2D and/or biopsy-verified NAFLD. Design: Cross-sectional cohort study. Patients: Patients with NAFLD with normal glucose tolerance, patients with NAFLD and T2D, patients with T2D without liver disease, and healthy controls. Interventions: Four-hour 50-g oral glucose tolerance test (OGTT) and an isoglycemic intravenous glucose infusion (IIGI). Main Outcome Measures: Collagen type 1 C-telopeptide (CTX), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone. Results: Plasma glucose levels achieved during OGTTs were successfully matched on corresponding IIGI days. Patients with NAFLD and T2D exhibited similar CTX suppression during the two glucose challenges (P = 0.46) and pronounced suppression of P1NP during IIGI compared with OGTT. Conversely, remaining groups showed greater (P < 0.05) CTX suppression during OGTT and similar suppression of bone formation markers during IIGI and OGTT. Conclusions: OGTT-induced CTX suppression seems to be impaired in patients with NAFLD and T2D, but preserved in patients with either NAFLD or T2D, suggesting that coexistence of T2D and NAFLD may affect gut-bone axis.

KW - Administration, Intravenous

KW - Administration, Oral

KW - Adult

KW - Aged

KW - Biomarkers/blood

KW - Blood Glucose/drug effects

KW - Bone Remodeling/physiology

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Diabetes Mellitus, Type 2/blood

KW - Female

KW - Glucose Tolerance Test

KW - Glucose/administration & dosage

KW - Humans

KW - Male

KW - Middle Aged

KW - Non-alcoholic Fatty Liver Disease/blood

U2 - 10.1210/jc.2018-00176

DO - 10.1210/jc.2018-00176

M3 - Journal article

C2 - 29506157

AN - SCOPUS:85046488269

VL - 103

SP - 2042

EP - 2049

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 5

ER -