Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark.
Curr Opin Endocrinol Diabetes Obes. 2023 Aug 1;30(4):206-212. doi: 10.1097/MED.0000000000000813. Epub 2023 Jun 12.
The incretin hormones, glucagon like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), have been shown to decrease bone resorption in humans. The aim of this review is to collate evidence and current advances in the research within the last year on the effect of incretins on skeletal health.
Preclinical studies show potential direct beneficial effects on bone by GLP-1 and GIP, however real world epidemiological data show no effects of GLP-1 receptor analogues on fracture risk. This may be due to the weight loss accompanied by GLP-1 treatment which may have detrimental effects on bone. GIP is shown to reduce bone resorption and increase bone formation. Further evidence suggests an additive effect of GIP and glucagon like peptide-2, which could affect bone by different mechanisms.
GIP and GLP-1 based therapies are more widespread used and may have potential beneficial effects on bone, possibly counterbalanced by weight loss. Long-term effects and side-effects of GIP or GIP/ GLP-2 co-administration remain to be elucidated, and longer term treatment trials are needed.
肠促胰岛素激素，胰高血糖素样肽-1（GLP-1）和胃抑制肽（GIP）已被证明可减少人类的骨吸收。本综述的目的是整理过去一年中关于肠促胰岛素对骨骼健康影响的研究证据和最新进展。
临床前研究显示 GLP-1 和 GIP 对骨骼有潜在的直接有益作用，然而，真实世界的流行病学数据显示 GLP-1 受体类似物对骨折风险没有影响。这可能是由于 GLP-1 治疗伴随的体重减轻对骨骼有不利影响。GIP 被证明可减少骨吸收并增加骨形成。进一步的证据表明 GIP 和胰高血糖素样肽-2 具有相加作用，这可能通过不同的机制影响骨骼。
基于 GIP 和 GLP-1 的治疗方法应用更为广泛，可能对骨骼有潜在的有益影响，但可能会被体重减轻所抵消。GIP 或 GIP/GLP-2 联合给药的长期效果和副作用仍有待阐明，需要进行更长时间的治疗试验。
