Short bowel syndrome: influence of nutritional therapy and incretin GLP1 on bone marrow adipose tissue

Parreiras-e-Silva, L.T.; Araújo, Iana Mizumukai de; Elías, Jorge; Nogueira-Barbosa, Marcello Henrique; Suen, Vivian M.M.; Marchini, Júlio Sérgio; Bonella, Jéssica; Nahas, Andressa Kutschenko; Salmon, Carlos Ernesto Garrido; Paula, Francisco José Albuquerque de

doi:10.1111/nyas.13657

Cited by 7 publications

(8 citation statements)

References 38 publications

(39 reference statements)

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“…There is evidence suggesting that GLP1 and GIP both stimulate bone formation 29 . A recent study observed that the serum levels of GLP1 have a positive relationship with MAT in individuals with SBS and that the circulatory levels of GIP are positively correlated with total hip BMD in normal patients 21 . Herein, the follow‐up of SBS individuals showed that the serum levels of GIP were greater in the latter determination than in the former, indicating the improvement in intestine adaptation.…”

Section: Discussionmentioning

confidence: 80%

“…In addition, there is a negative relationship between bone mass and MAT, supporting the tenet that adipogenesis in bone marrow occurs at the expense of bone formation 33 . A recent study showed that, unlike women with active anorexia nervosa, SBS patients receiving either parenteral or oral nutrition show both normal amounts of MAT and a positive relationship between MAT and bone mass 21 . Herein, it was observed that the SBSG, with a postsurgery mean time of 6 years, exhibited unchanged MAT and BMD after 1 year of subsequent follow‐up.…”

Section: Discussionmentioning

confidence: 94%

“…On the other hand, SBS patients showed increased intrahepatic lipids (IHLs), and there was a negative relationship between IHLs and bone mass in these individuals. The cross‐sectional study also called attention to the facts that individuals with SBS exhibit normal circulatory levels of incretins (ie, gastric inhibitory polypeptide [GIP] and glucagon‐like peptide‐1 [GLP1]) and that there was a positive association between GIP and bone mass 21 …”

Section: Introductionmentioning

confidence: 99%

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Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short‐Bowel Syndrome

Parreiras-e-Silva

Araújo

Elías

et al. 2020

J Parenter Enteral Nutr

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Background Osteoporosis has scarcely been prospectively investigated in short‐bowel syndrome (SBS). This prospective study was designed to evaluate incretins, adipokines, bone mass, and lipid deposits from marrow adipose tissue (MAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver (IHLs). Methods The study comprised 2 groups matched by gender, height, and age: the control group (CG) (9 males, 9 females) and the SBS group (SBSG) (6 males, 5 females). The SBSG was evaluated twice in an interval of 1 year (SBSG0 and SBSG1). The biochemical evaluation included incretins, leptin, and adiponectin. Dual‐energy x‐ray absorptiometry and magnetic resonance were, respectively, used to measure BMD and lipid deposits. Results Bone mineral density (BMD) was lower in the SBSG than in the CG, but there was no difference between SBSG0 and SBSG1. There was no difference in MAT, SAT, and VAT, but IHL was lower in CG than in SBSG0 and SBSG1. A negative correlation between MAT and third lumbar vertebrae BMD was found in the CG but not in SBSG0 or SBSG1. There was a negative association between IHL and bone mass considering all participants (CG and SBSG0) (R2 = 0.38; P < .05). Conclusion Appropriate nutrition assistance recovers body composition, reverts the relationship of bone mass and MAT, and mitigates bone loss in SBS. In spite of this, osteoporosis seems to be an early and persistent complication in SBS. Curiously, SBS seems to be a highly vulnerable condition for the development of hepatic steatosis and shows an association between bone mass and IHL.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short‐Bowel Syndrome

Parreiras-e-Silva

Araújo

Elías

et al. 2020

J Parenter Enteral Nutr

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“…Insulin resistance and its related disorder, nonalcoholic fatty liver disease (NAFLD), are two of the most common and severe complications associated with obesity. According to previous studies, hepatic accumulation of fat is negatively associated with bone mass in individuals with short bowel syndrome ( 22 , 23 ). However, studies evaluating the association of NAFLD and bone in individuals with obesity and T2DM have shown conflicting results, suggesting that factors other than the amount of intrahepatic lipids (IHL) mediate the relationship between liver and bone ( 24 , 25 ).…”

Section: Introductionmentioning

confidence: 90%

Hashtag bone: detrimental effects on bone contrast with metabolic benefits one and five years after Roux-en-Y gastric bypass

Alencar¹,

Araújo²,

Parreiras-e-Silva³

et al. 2021

Braz J Med Biol Res

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Bone loss is a potential adverse consequence of rapid and sustained weight loss after bariatric surgery. The aim of the present study was to evaluate the bone mass, body fat distribution, and metabolic parameters in women submitted to Roux-en-Y gastric bypass (RYGB). The study included the following three groups: one group of lean women (control [C] group) and two groups of obese women, one evaluated one year (B1) and the other five years (B5) after RYGB. Dual-energy X-ray absorptiometry and magnetic resonance imaging were used to determine bone mineral density (BMD; lumbar spine, total hip, and femoral neck) and abdominal fat content (subcutaneous [SAT] and visceral [VAT] adipose tissues, and intrahepatic lipids [IHL]). The BMD/body mass index ratio was lower in the B5 compared with the C group at all sites. Serum C-terminal telopeptide of type I collagen (CTX) levels were higher in the B1 and B5 groups compared with the C group. Individuals submitted to RYGB showed greater SAT but similar VAT and IHL values compared with those in the C group. However, the B5 group had higher mean parathyroid hormone levels compared with the other two groups. Individuals submitted to RYGB presented increased levels of CTX and low BMD for body weight than those in the C group, suggesting that bone catabolism is a persistent alteration associated with RYGB. In conclusion, the long-lasting metabolic benefits obtained with RYGB in obesity are counterbalanced by a persistent catabolic effect of the procedure on bone and mineral metabolism.

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“…[15] The interaction between adipose tissue and the skeleton has an additional ingredient, as special adipocytes within marrow adipose tissue (MAT) are part of the universe of cells composing the bone marrow. MAT, at least in humans, shows crucial adaptive differences in response to nutritional fluctuations by expanding during periods of calorie restriction while appearing not to be a site for fat storage during calorie surplus [13, 16, 17]. Previous studies show that MAT expands in patients with autoimmune diseases submitted to glucocorticoid therapy, as well as in individuals diagnosed with CD [15, 18].…”

Section: Introductionmentioning

confidence: 99%

Beyond the metabolic syndrome: Visceral and marrow adipose tissues impair bone quantity and quality in Cushing’s disease

et al. 2019

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The present study was designed to evaluate the relationship between bone traits [bone mineral density (BMD) and trabecular bone score (TBS)] and the accumulation of fat in adipose tissues [abdominal subcutaneous (SAT), visceral (VAT), marrow (MAT) and intrahepatic lipids (IHL)], as well as insulin resistance, in subjects with Cushing’s disease (CD). The study included control (C = 27), paired (P = 16) and Cushing’s disease (CD = 10) groups, which underwent biochemical assessment, dual X-ray absorptiometry, TBS, and magnetic resonance imaging to determine fat deposits. The CD group showed higher serum levels of glucose and insulin, as well as HOMA-IR values, but lower circulatory levels of osteocalcin, in comparison to C and P. The CD group exhibited lower L1-L4 BMD than P (P = 1.059 ± 0.141 vs CD = 0.935 ± 0.093 g/cm2, p < 0.05) (Fig 1A). The lumbar spine BMD from the C group was similar to the other groups. TBS was lower in CD than in P and C (C = 1.512±0.077 vs P = 1.405±0.150 vs CD = 1.135±0.136; p<0.05); there was also significant difference between C and P (p<0.05). MAT, VAT, and IHL were higher in CD than in C and P (p<0.05). Considering all subjects, there was a positive association between TBS with both lumbar spine BMD (R2 = 0.45; p<0.0001) and osteocalcin (R2 = 0.44; p = 0.05). TBS was negatively associated with MAT (R2 = 0.49; p = 0.01), VAT (R2 = 0.55; p<0.05), and HOMA-IR (R2 = 0.44; p<0.01). MAT was positively related with VAT (R2 = 0.44; p<0.01) and IHL (R2 = 0.41; p<0.05). In CD, insulin resistance and adipose tissue dysfunction, including high MAT, are active players in bone deterioration, as confirmed by lower lumbar spine BMD and lower TBS. Thus, our findings point to an additional component of the already well-known complex mechanisms of osteoporosis associated with hypercortisolism.

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Short bowel syndrome: influence of nutritional therapy and incretin GLP1 on bone marrow adipose tissue

Cited by 7 publications

References 38 publications

Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short‐Bowel Syndrome

Osteoporosis and Hepatic Steatosis: 2 Closely Related Complications in Short‐Bowel Syndrome

Hashtag bone: detrimental effects on bone contrast with metabolic benefits one and five years after Roux-en-Y gastric bypass

Beyond the metabolic syndrome: Visceral and marrow adipose tissues impair bone quantity and quality in Cushing’s disease

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