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Ling W, Huang YM, Qiao YC, Zhang XX, Zhao HL. Human Amylin: From Pathology to Physiology and Pharmacology. Curr Protein Pept Sci 2019; 20:944-957. [DOI: 10.2174/1389203720666190328111833] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 12/18/2022]
Abstract
The histopathological hallmark of type 2 diabetes is islet amyloid implicated in the developing treatment options. The major component of human islet amyloid is 37 amino acid peptide known as amylin or islet amyloid polypeptide (IAPP). Amylin is an important hormone that is co-localized, copackaged, and co-secreted with insulin from islet β cells. Physiologically, amylin regulates glucose homeostasis by inhibiting insulin and glucagon secretion. Furthermore, amylin modulates satiety and inhibits gastric emptying via the central nervous system. Normally, human IAPP is soluble and natively unfolded in its monomeric state. Pathologically, human IAPP has a propensity to form oligomers and aggregate. The oligomers show misfolded α-helix conformation and can further convert themselves to β-sheet-rich fibrils as amyloid deposits. The pathological findings and physiological functions of amylin have led to the introduction of pramlintide, an amylin analog, for the treatment of diabetes. The history of amylin’s discovery is a representative example of how a pathological finding can translate into physiological exploration and lead to pharmacological intervention. Understanding the importance of transitioning from pathology to physiology and pharmacology can provide novel insight into diabetes mellitus and Alzheimer's disease.
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Affiliation(s)
- Wei Ling
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China
| | - Yan-Mei Huang
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China
| | - Yong-Chao Qiao
- Department of Laboratory, the Affiliated Hospital of Guilin Medical University, Guilin 541004, China
| | - Xiao-Xi Zhang
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China
| | - Hai-Lu Zhao
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China
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2
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Mietlicki-Baase EG. Amylin in Alzheimer's disease: Pathological peptide or potential treatment? Neuropharmacology 2018; 136:287-297. [PMID: 29233636 PMCID: PMC5994175 DOI: 10.1016/j.neuropharm.2017.12.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 12/19/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease for which we currently lack effective treatments or a cure. The pancreatic peptide hormone amylin has recently garnered interest as a potential pharmacological target for the treatment of AD. A number of studies have demonstrated that amylin and amylin analogs like the FDA-approved diabetes drug pramlintide can reduce amyloid burden in the brain and improve cognitive symptoms of AD. However, other data suggest that amylin may have pathological effects in AD due to its propensity to misfold and aggregate under certain conditions. Here, the literature supporting a beneficial versus harmful role of amylin in AD is reviewed. Additionally, several critical gaps in the literature are discussed, such as our limited understanding of the amylin system during aging and in disease states, as well as complexities of amylin receptor signaling and of changing pathophysiology during AD progression that might underlie the seemingly conflicting or contradictory results in the amylin/AD literature. This article is part of the Special Issue entitled 'Metabolic Impairment as Risk Factors for Neurodegenerative Disorders.'
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Affiliation(s)
- Elizabeth G Mietlicki-Baase
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA.
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3
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Cui J, Liu H, Shao J, Xu DM, Wang Y, Fei Z, Wei J, Lu W, Wang CR, He R, Tan Y, Fan Y, Ning Y, Cassidy RM, Soares JC, Huang X, Zhang XY. Prevalence, risk factors and clinical characteristics of osteoporosis in Chinese inpatients with schizophrenia. Schizophr Res 2018; 195:488-494. [PMID: 29056492 DOI: 10.1016/j.schres.2017.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/12/2017] [Accepted: 10/15/2017] [Indexed: 11/26/2022]
Abstract
Patients with schizophrenia have a high prevalence of developing osteoporosis and osteoporosis-related fractures. We examined the prevalence of osteoporosis and its clinical correlates in Chinese patients with schizophrenia, which is not well-studied. A total of 199 inpatients (males/females=132/67; average age: 54.5±11.1years) and 107 healthy controls (males/females=22/85; average age: 41.7±11.9years) were recruited. Bone mineral density (BMD) was measured by ultrasonography of the calcaneus. The prevalence of osteoporosis and low BMD (osteoporosis and osteopenia) was 23.1% and 65.3% for the patient group, versus 7.5% and 39.3% for the control group (both p<0.001). Further, the average BMD T-score in patients was significantly lower than in controls (p<0.05). There was gender difference in the prevalence of low BMD conditions for the patients (males: 56.1% versus females: 76.1%; p<0.01) as well as the BMD T-score (p<0.001). Several risk factors correlated with the osteoporosis classification in the patient group: older age (58.9±11.2years vs. 53.3±11.0years), lower weight (63.7±12.2kg vs. 70.4±15.2kg) and body mass index (BMI) (22.8±4.1kg/m2 vs. 24.2±4.7kg/m2; all p<0.01) than those without osteoporosis. Stepwise multiple logistic regression analysis indicated that age, weight and BMI remained significantly associated with osteoporosis. In addition, correlation analysis showed significant correlations between BMD T-score and the following parameters: gender, age and drug type (clozapine versus non-clozapine) (Bonferroni corrected p's<0.05). Our results suggest a higher prevalence of osteoporosis and osteopenia in Chinese schizophrenic inpatients, with both the expected risk factors of gender and age, as well as drug type.
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Affiliation(s)
- Jingyi Cui
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Huaqing Liu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jing Shao
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dong-Mei Xu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yi Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zheng Fei
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jiyu Wei
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Wei Lu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Chun-Rong Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Rui He
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yangya Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yi Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
| | - Ryan M Cassidy
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China.
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Abstract
Diabetes be it type 1 or type 2 is associated with an increased risk of fragility fractures. The mechanisms underlying this increased risk are just being elucidated. Anti-diabetes medications are crucial for maintaining glucose control and for preventing micro- and macrovascular complications in diabetes. However, they may modulate fracture risk in diabetes in different ways. Thiazolidinediones have demonstrated an unfavorable effect on the skeleton, while metformin and sulfonylureas may have a neutral if not beneficial effect on bone. The use of insulin has been associated with an increased risk of fragility fractures though it is not clear whether it is due to direct influence of insulin or whether it is mediated through hypoglycemia and increased falls risk. The overall effect of incretin mimetics appears to be beneficial; however, this has to be elucidated further. The bone effects of pramlintide, a synthetic analog of amylin, have not been explored fully. Finally, issues regarding bone safety of SGLT2 (sodium-dependent glucose transporter 2) inhibitors, the newest anti-diabetic medications on the market are of concern. The purpose of this review is to provide a comprehensive overview of the effect of these medications on bone metabolism and the studies exploring the risk or lack thereof of these medications on bone loss and fragility fractures.
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Affiliation(s)
- Manju Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, ACADEMIA, 20 College Road, Singapore, 169856, Singapore.
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5
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Amso Z, Cornish J, Brimble MA. Short Anabolic Peptides for Bone Growth. Med Res Rev 2016; 36:579-640. [DOI: 10.1002/med.21388] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 01/24/2016] [Accepted: 02/15/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Zaid Amso
- School of Chemical Sciences; The University of Auckland, 23 Symonds St; Auckland 1142 New Zealand
| | - Jillian Cornish
- Department of Medicine; The University of Auckland; Auckland 1010 New Zealand
| | - Margaret A. Brimble
- School of Chemical Sciences; The University of Auckland, 23 Symonds St; Auckland 1142 New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences; The University of Auckland; Auckland 1142 New Zealand
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6
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Amylin-mediated control of glycemia, energy balance, and cognition. Physiol Behav 2016; 162:130-40. [PMID: 26922873 DOI: 10.1016/j.physbeh.2016.02.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/20/2016] [Accepted: 02/22/2016] [Indexed: 12/26/2022]
Abstract
Amylin, a peptide hormone produced in the pancreas and in the brain, has well-established physiological roles in glycemic regulation and energy balance control. It improves postprandial blood glucose levels by suppressing gastric emptying and glucagon secretion; these beneficial effects have led to the FDA-approved use of the amylin analog pramlintide in the treatment of diabetes mellitus. Amylin also acts centrally as a satiation signal, reducing food intake and body weight. The ability of amylin to promote negative energy balance, along with its unique capacity to cooperatively facilitate or enhance the intake- and body weight-suppressive effects of other neuroendocrine signals like leptin, have made amylin a leading target for the development of novel pharmacotherapies for the treatment of obesity. In addition to these more widely studied effects, a growing body of literature suggests that amylin may play a role in processes related to cognition, including the neurodegeneration and cognitive deficits associated with Alzheimer's disease (AD). Although the function of amylin in AD is still unclear, intriguing recent reports indicate that amylin may improve cognitive ability and reduce hallmarks of neurodegeneration in the brain. The frequent comorbidity of diabetes mellitus and obesity, as well as the increased risk for and occurrence of AD associated with these metabolic diseases, suggests that amylin-based pharmaceutical strategies may provide multiple therapeutic benefits. This review will discuss the known effects of amylin on glycemic regulation, energy balance control, and cognitive/motivational processes. Particular focus will be devoted to the current and/or potential future clinical use of amylin pharmacotherapies for the treatment of diseases in each of these realms.
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7
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Abstract
Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fractures despite increased body weight and normal or higher bone mineral density. The mechanisms by which T2DM increases skeletal fragility are unclear. It is likely that a combination of factors, including a greater risk of falling, regional osteopenia, and impaired bone quality, contributes to the increased fracture risk. Drugs for the treatment of T2DM may also impact on the risk for fractures. For example, thiazolidinediones accelerate bone loss and increase the risk of fractures, particularly in older women. In contrast, metformin and sulfonylureas do not appear to have a negative effect on bone health and may, in fact, protect against fragility fracture. Animal models indicate a potential role for incretin hormones in bone metabolism, but there are only limited data on the impact of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists on bone health in humans. Animal models also have demonstrated a role for amylin in bone metabolism, but clinical trials in patients with type 1 diabetes with an amylin analog (pramlintide) have not shown a significant impact on bone metabolism. The effects of insulin treatment on fracture risk are inconsistent with some studies showing an increased risk and others showing no effect. Finally, although there is limited information on the latest class of medications for the treatment of T2DM, the sodium-glucose co-transporter-2 inhibitors, these drugs do not seem to increase fracture risk. Because diabetes is an increasingly common chronic condition that can affect patients for many decades, further research into the effects of agents for the treatment of T2DM on bone metabolism is warranted. In this review, the physiological mechanisms and clinical impact of diabetes treatments on bone health and fracture risk in patients with T2DM are described.
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Affiliation(s)
- Matthew P Gilbert
- Division of Endocrinology and Diabetes (M.P.G.), The University of Vermont College of Medicine, Burlington, Vermont 05405; and Florida Hospital Diabetes and Translational Research Institutes and Sanford-Burnham Medical Research Institute, Orlando, Florida 32827
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Wauquier F, Léotoing L, Philippe C, Spilmont M, Coxam V, Wittrant Y. Pros and cons of fatty acids in bone biology. Prog Lipid Res 2015; 58:121-45. [PMID: 25835096 DOI: 10.1016/j.plipres.2015.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 03/06/2015] [Accepted: 03/23/2015] [Indexed: 12/12/2022]
Abstract
Despite the growing interest in deciphering the causes and consequences of obesity-related disorders, the mechanisms linking fat intake to bone behaviour remain unclear. Since bone fractures are widely associated with increased morbidity and mortality, most notably in elderly and obese people, bone health has become a major social and economic issue. Consistently, public health system guidelines have encouraged low-fat diets in order to reduce associated complications. However, from a bone point of view, mechanisms linking fat intake to bone alteration remain quite controversial. Thus, after more than a decade of dedicated studies, this timely review offers a comprehensive overview of the relationships between bone and fatty acids. Using clinical evidences as a starting-point to more complex molecular elucidation, this work highlights the complexity of the system and reveals that bone alteration that cannot be solved simply by taking ω-3 pills. Fatty acid effects on bone metabolism can be both direct and indirect and require integrated investigations. Furthermore, even at the level of a single cell, one fatty acid is able to trigger several different independent pathways (receptors, metabolites…) which may all have a say in the final cellular metabolic response.
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Affiliation(s)
- Fabien Wauquier
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Laurent Léotoing
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Claire Philippe
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Mélanie Spilmont
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Véronique Coxam
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France
| | - Yohann Wittrant
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63009 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; Equipe Alimentation, Squelette et Métabolismes, France.
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9
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Guzel S, Gunes N. Correlations between endogen amylin hormone and some hormonal, biochemical and bone parameters in pullets. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2014. [DOI: 10.1590/1516-635x1604375-380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- S Guzel
- University of Uludag, TURKEY
| | - N Gunes
- University of Uludag, TURKEY
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10
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Abstract
Diabetes mellitus (particularly type 2) and osteoporosis are two very common disorders, and both are increasing in prevalence. Adolescents with type 1 diabetes mellitus may not reach potential peak bone mass, putting them at greater fracture risk. In adults with type 2 diabetes, fracture risk is increased and is not explained by the bone mineral density measured by dual-energy X-ray absorptiometry, still considered the gold standard predictor of fracture. In this review, we explore potential mechanisms behind the increased fracture risk that occurs in patients with diabetes, even those with increased bone mineral density. One potential link between diabetes and bone is the osteoblast-produced factor, osteocalcin. It remains to be established whether osteocalcin reflects or affects the connection between bone and glucose metabolism. Several other potential mediators of the effects of diabetes on bone are discussed.
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Affiliation(s)
- Robert Sealand
- Endocrinology (111P), McGuire Veterans Affairs Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
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Gutiérrez-Rojas I, Lozano D, Nuche-Berenguer B, Moreno P, Acitores A, Ramos-Álvarez I, Rovira A, Novials A, Martín-Crespo E, Villanueva-Peñacarrillo ML, Esbrit P. Amylin exerts osteogenic actions with different efficacy depending on the diabetic status. Mol Cell Endocrinol 2013. [PMID: 23178165 DOI: 10.1016/j.mce.2012.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Amylin displays osteogenic features, but its role in diabetic osteopenia is unclear. We examined the possible osteogenic action of amylin infusion for 3days into fructose-induced insulin-resistant (IR) and streptozotocin-induced type 2 diabetic (T2D) and normal (N) rats. Amylin failed to affect glycaemia or parathyroid hormone levels in any group, but reduced hyperinsulinemia in IR rats. In N rats, amylin increased bone formation rate and reduced osteoclast surface and erosive surface in the femoral metaphysis, and increased osteoprotegerin (OPG)/receptor activator of NFκB ligand (RANKL) mRNA ratio in the tibia. In T2D rats, amylin normalized trabecular structure parameters and increased osteoblast number and osteocalcin (OC) expression in long bones. In contrast, in IR rats, no apparent osteogenic effect of amylin in the femur was observed, although both OC and OPG/RANKL ratio were increased in the tibia. Our findings demonstrate a different osteogenic efficacy of amylin in two diabetic settings.
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Affiliation(s)
- I Gutiérrez-Rojas
- Departamento de Metabolismo, Nutrición y Hormonas, Instituto de Investigación Sanitaria (IIS)-Fundación Jiménez Díaz, Madrid, Spain
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12
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Amelio PD, Panico A, Spertino E, Isaia GC. Energy metabolism and the skeleton: Reciprocal interplay. World J Orthop 2012; 3:190-8. [PMID: 23330074 PMCID: PMC3547113 DOI: 10.5312/wjo.v3.i11.190] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 07/31/2012] [Accepted: 10/20/2012] [Indexed: 02/06/2023] Open
Abstract
The relation between bone remodelling and energy expenditure is an intriguing, and yet unexplained, challenge of the past ten years. In fact, it was only in the last few years that the skeleton was found to function, not only in its obvious roles of body support and protection, but also as an important part of the endocrine system. In particular, bone produces different hormones, like osteocalcin (OC), which influences energy expenditure in humans. The undercarboxylated form of OC has a reduced affinity for hydroxyapatite; hence it enters the systemic circulation more easily and exerts its metabolic functions for the proliferation of pancreatic β-cells, insulin secretion, sensitivity, and glucose tolerance. Leptin, a hormone synthesized by adipocytes, also has an effect on both bone remodelling and energy expenditure; in fact it inhibits appetite through hypothalamic influence and, in bone, stimulates osteoblastic differentiation and inhibits apoptosis. Leptin and serotonin exert opposite influences on bone mass accrual, but several features suggest that they might operate in the same pathway through a sympathetic tone. Serotonin, in fact, acts via two opposite pathways in controlling bone remodelling: central and peripheral. Serotonin product by the gastrointestinal tract (95%) augments bone formation by osteoblast, whereas brain-derived serotonin influences low bone mineral density and its decrease leads to an increase in bone resorption parameters. Finally, amylin (AMY) acts as a hormone that alters physiological responses related to feeding, and plays a role as a growth factor in bone. In vitro AMY stimulates the proliferation of osteoblasts, and osteoclast differentiation. Here we summarize the evidence that links energy expenditure and bone remodelling, with particular regard to humans.
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Blakytny R, Spraul M, Jude EB. Review: The diabetic bone: a cellular and molecular perspective. INT J LOW EXTR WOUND 2011; 10:16-32. [PMID: 21444607 DOI: 10.1177/1534734611400256] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
With the increasing worldwide prevalence of diabetes the resulting complications, their consequences and treatment will lead to a greater social and financial burden on society. One of the many organs to be affected is bone. Loss of bone is observed in type 1 diabetes, in extreme cases mirroring osteoporosis, thus a greater risk of fracture. In the case of type 2 diabetes, both a loss and an increase of bone has been observed, although in both cases the quality of the bone overall was poorer, again leading to a greater risk of fracture. Once a fracture has occurred, healing is delayed in diabetes, including nonunion. The reasons leading to such changes in the state of the bone and fracture healing in diabetes is under investigation, including at the cellular and the molecular levels. In comparison with our knowledge of events in normal bone homeostasis and fracture healing, that for diabetes is much more limited, particularly in patients. However, progress is being made, especially with the use of animal models for both diabetes types. Identifying the molecular and cellular changes in the bone in diabetes and understanding how they arise will allow for targeted intervention to improve diabetic bone, thus helping to counter conditions such as Charcot foot as well as preventing fracture and accelerating healing when a fracture does occur.
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14
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Feeding and bone. Arch Biochem Biophys 2010; 503:11-9. [DOI: 10.1016/j.abb.2010.06.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/17/2010] [Accepted: 06/18/2010] [Indexed: 11/23/2022]
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Salari Sharif P, Abdollahi M, Larijani B. Current, new and future treatments of osteoporosis. Rheumatol Int 2010; 31:289-300. [PMID: 20676643 DOI: 10.1007/s00296-010-1586-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Accepted: 07/14/2010] [Indexed: 11/24/2022]
Abstract
Osteoporosis as a common chronic disease is challenging human health. Although different therapeutic options are routinely used for prevention/treatment of osteoporosis, their side effects and benefits are under question. Increasing our knowledge about signaling pathways in bone and osteocytes as well as osteoblasts and osteoclasts will help us in designing new therapeutic modalities for osteoporosis. In the present study, all new therapeutic measures of osteoporosis have been reviewed. For this purpose, search engines like Pubmed, Web of Science, Scopus, Google Scholar were searched and all relevant articles were found. The study was limited to the year 1998-2010. Bisphosphonates are the cornerstone of osteoporosis treatment, but there are not enough relevant studies that investigated their equivalencies in comparison with each other or the other medications. Therefore, medication selection is empirical and subjective. Furthermore, no eminent study has compared certain combinations. There are new hopes for treatment of osteoporosis, which are more specific with less harm. Our results show that new and emerging therapies are more potent and target specified which more individualize osteoporosis treatment; however, more investigations on their safety and efficacy in comparison with current medications are highly recommended.
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Affiliation(s)
- Pooneh Salari Sharif
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, 3rd floor, 21# 16 Azar Ave, Tehran, Iran.
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16
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Wojcik MH, Meenaghan E, Lawson EA, Misra M, Klibanski A, Miller KK. Reduced amylin levels are associated with low bone mineral density in women with anorexia nervosa. Bone 2010; 46:796-800. [PMID: 19931436 PMCID: PMC2824019 DOI: 10.1016/j.bone.2009.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 10/23/2009] [Accepted: 11/11/2009] [Indexed: 11/27/2022]
Abstract
CONTEXT Anorexia nervosa, characterized by extreme low body weight due to reduced nutrient intake, is associated with severe bone loss. Peptide hormones, including amylin, GIP, and GLP2, are released immediately after nutrient intake and may be involved in the regulation of bone turnover. OBJECTIVE To investigate fasting levels of amylin, GIP, and GLP2 and their relationships with bone mineral density (BMD) in women with anorexia nervosa compared to healthy controls. DESIGN Cross-sectional. SETTING Clinical Research Center. STUDY PARTICIPANTS 15 women with anorexia nervosa and 16 healthy controls. INTERVENTION None. MAIN OUTCOME MEASURES Fasting serum amylin, GIP, and GLP2, and BMD. RESULTS Women with anorexia nervosa had significantly lower fasting serum amylin and GIP levels than healthy controls. Fasting serum GLP2 levels were not significantly different between groups. Fasting amylin levels were positively associated with BMD and Z-score at the PA spine, total hip, and femoral neck. Fasting amylin levels were also positively associated with weight and percent fat; after controlling for these variables, amylin was still a significant predictor of BMD and Z-score at the femoral neck and of Z-score at the total hip. In the anorexia nervosa group, there was a trend toward an inverse association between amylin and C-terminal telopeptide (CTX) levels (R=-0.47, p=0.08). GIP and GLP2 levels did not predict BMD at any site. CONCLUSION Decreased secretion of amylin may be a mechanism through which reduced nutrient intake adversely affects BMD in anorexia nervosa.
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Affiliation(s)
- Monica H Wojcik
- Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Abstract
PURPOSE OF REVIEW To outline recent developments in research surrounding gastrointestinal peptides and their role in skeletal regulation. RECENT FINDINGS Bone remodeling is influenced by many regulatory systems, which interact to ensure that the complex demands upon mineralized tissue are met without undue compromise. These include local actions such as mechanical factors, but are dominated by systemic endocrine factors. Although the involvement of hypothalamo-pituitary actions on bone homeostasis is well defined, growing evidence suggests that peripheral tissues and the circulating factors they produce represent an important regulatory axis in bone. Given the critical role of diet in mineral homeostasis, the gastrointestinal tract is a rich source of circulating factors capable of regulating bone homeostasis. After a review of manuscripts on known mechanisms and effects of gastrointestinal peptide on bone, these were summarized. SUMMARY Although clearly an exciting and emergent field of research, more studies are required to define the specific actions of gastrointestinal regulator in bone, in particular, the relative contribution of systemic and local effects, to aid interpretation of their potential impact on human health and disease. Nonetheless, this exciting research will further our understanding on bone physiology and provide novel approaches to therapy in a wide range of skeletal conditions.
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Affiliation(s)
- Iris Pl Wong
- Osteoporosis and Bone Biology Program, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, New South Wales, Australia
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Akdeniz N, Akpolat V, Kale A, Erdemoglu M, Kuyumcuoglu U, Celik Y. Risk factors for postmenopausal osteoporosis: anthropometric measurements, age, age at menopause and the time elapsed after menopause onset. Gynecol Endocrinol 2009; 25:125-9. [PMID: 19253109 DOI: 10.1080/09513590802549817] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine, how much the anthropometric measurements and age affect the femur and vertebra T-scores by using correlation and regression analysis in postmenopausal women. METHODS Data of 540 healthy postmenopausal women were included in this analysis. Bone mineral density was determined by dual energy X-ray absorptiometry (DXA). The data of the patients related to height, weight, age, age at menopause were obtained from records, and body mass index (BMI) was calculated (BMI = W (kg)/H(m(2))). Statistical analyses were performed with SPSS 15.0 for Windows (SPSS, Chicago, IL). RESULTS Mean age and standard deviation of 540 postmenopausal women was 59.3 +/- 8.4 years. The correlation coefficients among femur, vertebra T-scores, weight, the time elapsed after the menopause onset, age, BMI and height were found as follows, from higher to lower values with 0.465, 0.453, 0.411, 0.382, 0.232, respectively, and were statistically significant (p < 0.001). CONCLUSIONS We determined the effects of the anthropometric measurements on osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.
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Affiliation(s)
- Nurten Akdeniz
- Department of Obstetrics and Gynecology, Dicle University, Diyarbakir, Turkey.
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19
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[Diabetes mellitus--a risk factor for the development of osteoporosis]. VOJNOSANIT PREGL 2008; 65:692-8. [PMID: 18814506 DOI: 10.2298/vsp0809692v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
<zakljucak> Osteoporoza je vazan zdravstveni problem. Prisutan je kod svake trece zene u postmenopauzi i povezuje se sa znacajnim morbiditetom i mortalitetom. Zene sa dijabetesom u postmenopauzi imaju povecan rizik od preloma kuka nego zene koje nisu dijabeticari, tako da strategija prevencije osteoporoze kod svih bolesnika sa dijabetesom ima smisla, narocito kod zena obolelih od dijabetesa. Dokazi da populacija starih sa dijabetesom ima povecan rizik od fraktura kosti daju novi podsticaj za dalja istrazivanja fokusirana na kost i dijabetes. Ona bi trebala da razjasne uticaj razlicitih aspekata dijabetesnog metabolizma, poboljsanja kontrole glikemije i uticaja lecenja dijabetesa na kosti. Odredjivanje (procena) kvaliteta kosti ukljucivala bi standarde merenja BMD, kao i razvoj novih pristupa merenju glikoziliranog kolagena. Bolje shvatanje i sagledavanje uticaja dijabetesa na kost povecava mogucnost ocuvanja kosti i preveniranja pojave fraktura kod osoba sa dijabetesom. Takodje, neophodno je ustanoviti optimalni izbor ispitivanih biohemijskih markera i napraviti standardizaciju merenja kostane mase kod obolelih od dijabetesa. U klinickoj praksi pristup bolesniku sa dijabetesnom osteopatijom trebalo bi da bude individualan, prema stanju promena i profilu rizika, a da dijagnostikovanje i terapijski postupci postanu rutina.
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20
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Silva HGVD, Mendonça LM, Conceição FL, Zahar SE, Farias MLF. Influence of obesity on bone density in postmenopausal women. ACTA ACUST UNITED AC 2007; 51:943-9. [DOI: 10.1590/s0004-27302007000600008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 03/06/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To evaluate the influence of obesity, age, and years since menopause on bone density. METHODS: A retrospective analysis of bone mineral density (BMD) obtained from 588 women, 41 to 60 years, previously menopaused (1-10 years before). RESULTS: Positive influence of obesity was confirmed by the significant differences in BMD at lumbar spine, femoral neck (FN), and trochanter (TR) between the groups (p < 0.01). Age and years since menopause (YSM) were negatively correlated with BMD at all sites (p = 0.000). Comparing patients within 1 to < 6 YSM versus 6 to 10 YSM, BMD was higher in the former at LS and FN (p < 0.005), despite the higher BMI in the older group (p = 0.01). Obese patients had a lower prevalence of osteoporosis at LS and FN (p = 0.009). Regression analysis identified BMI as the strongest determinant of FN and TR BMD, while YSM was the strongest determinant of LS BMD. CONCLUSION: The protective effect of obesity is overtaken by age and estradiol deficiency. We recommend that even obese postmenopausal women should be screened for osteoporosis.
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21
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Bronsky J, Karpísek M, Bronská E, Pechová M, Jancíková B, Kotolová H, Stejskal D, Prusa R, Nevoral J. Adiponectin, Adipocyte Fatty Acid Binding Protein, and Epidermal Fatty Acid Binding Protein: Proteins Newly Identified in Human Breast Milk. Clin Chem 2006; 52:1763-70. [PMID: 16873294 DOI: 10.1373/clinchem.2005.063032] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Abstract
Background: Breastfeeding may protect children from developing metabolic syndrome and other diseases later in life. We investigated novel proteins in human breast milk that might play a role in this process.
Methods: We used ELISA to measure adiponectin, adipocyte and epidermal fatty acid binding proteins (AFABP, EFABP), and leptin concentrations in human breast milk obtained from 59 mothers 48 h after initiation of lactation. Using a questionnaire and medical records, we collected information about the mothers and newborns.
Results: Mean (SE) adiponectin concentrations in breast milk were 13.7 (0.8), range 3.9–30.4 μg/L; AFABP concentrations 26.7 (4.4), range 1.2–137.0 μg/L; EFABP concentrations 18.1 (1.4), range 0.8–47.0 μg/L; and leptin concentrations 0.50 (0.05), range 0–1.37 μg/L. We found a significant correlation between AFABP and EFABP concentrations (r = 0.593, P <0.0001). Maternal EFABP concentrations were significantly higher in mothers who delivered boys than in those who delivered girls [21.7 (2.3) vs 15.4 (1.7) μg/L, P = 0.028] and correlated with newborn birth weight (r = 0.266, P = 0.045). Maternal leptin correlated with body weight before pregnancy (r = 0.272, P = 0.043) and at delivery (r = 0.370, P = 0.005), body mass index before pregnancy (r = 0.397, P = 0.003) and at delivery (r = 0.498, P <0.0001), body weight gain during pregnancy (r = 0.267, P = 0.047), and newborn gestational age (r = 0.266, P = 0.048). Leptin was significantly lower in mothers who delivered preterm vs term babies [0.30 (0.09) vs 0.60 (0.05) ug/L, P = 0.026].
Conclusions: Concentrations of adiponectin, AFABP, and EFABP in human breast milk are related to nutritional variables of mothers and newborns and thus may play a role in the protective effects of breastfeeding.
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Affiliation(s)
- Jirí Bronsky
- Pediatric Gastroenterology Unit, Pediatric Clinic, 2nd Medical Faculty, Charles University and University Hospital Motol, Prague, Czech Republic.
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22
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Bronský J, Průsa R, Nevoral J. The role of amylin and related peptides in osteoporosis. Clin Chim Acta 2006; 373:9-16. [PMID: 16797521 DOI: 10.1016/j.cca.2006.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2006] [Revised: 05/02/2006] [Accepted: 05/05/2006] [Indexed: 12/18/2022]
Abstract
Osteoporosis is a systemic skeletal disorder that remains a major public health problem due to significant fracture-associated morbidity and mortality. Because it has been shown that individuals having type I diabetes mellitus also suffer from osteopenia or osteoporosis, there is probably a pathophysiological mechanism that links pancreatic beta cell insufficiency with inappropriate bone formation. Many factors have been suggested, including amylin, a product of pancreatic beta cells with structural and functional similarity to calcitonin. Amylin has been shown to stimulate bone development via action on osteoblasts and osteoclasts. Recently, amylin receptors have been identified as complexed calcitonin receptor with receptor activity modifying proteins. Moreover, a synthetic amylin analogue (pramlintide) has been developed for clinical use. These findings including results from in vitro animal and human studies suggest a role for amylin as a potential diagnostic and therapeutical tool in patients with various bone diseases including osteoporosis. However, other structurally and functionally related hormones that affect bone metabolism should also be taken in account including calcitonin, calcitonin gene-related peptide and adrenomedullin.
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Affiliation(s)
- Jirí Bronský
- Department of Clinical Biochemistry and Pathobiochemistry, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic.
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