Beyond glycemic control in diabetes mellitus: Effects of incretin-based therapies on bone metabolism

Elena Ceccarelli, Elisa G. Guarino, Daniela Merlotti, Aurora Patti, Luigi Gennari, Ranuccio Nuti, Francesco Dotta

Research output: Contribution to journalArticle

Abstract

Diabetes mellitus (DM) and osteoporosis (OP) are common disorders with a significant health burden, and an increase in fracture risk has been described both in type 1 (T1DM) and in type 2 (T2DM) diabetes. The pathogenic mechanisms of impaired skeletal strength in diabetes remain to be clarified in details and they are only in part reflected by a variation in bone mineral density. In T2DM, the occurrence of low bone turnover together with a decreased osteoblast activity and compromised bone quality has been shown. Of note, some antidiabetic drugs (e.g., thiazolidinediones, insulin) may deeply affect bone metabolism. In addition, the recently introduced class of incretin-based drugs (i.e., GLP-1 receptor agonists and DPP-4 inhibitors) is expected to exert potentially beneficial effects on bone health, possibly due to a bone anabolic activity of GLP-1, that can be either direct or indirect through the involvement of thyroid C cells. Here we will review the established as well as the putative effects of incretin hormones and of incretin-based drugs on bone metabolism, both in preclinical models and in man, taking into account that such therapeutic strategy may be effective not only to achieve a good glycemic control, but also to improve bone health in diabetic patients.

Original languageEnglish
Article numberArticle 73
JournalFrontiers in Endocrinology
Volume4
Issue numberJUN
DOIs
Publication statusPublished - 2013

Fingerprint

Incretins
Diabetes Mellitus
Bone and Bones
Health
Therapeutics
Thiazolidinediones
Glucagon-Like Peptide 1
Bone Remodeling
Osteoblasts
Hypoglycemic Agents
Pharmaceutical Preparations
Bone Density
Type 2 Diabetes Mellitus
Osteoporosis
Thyroid Gland
Hormones
Insulin

Keywords

  • Bone metabolism
  • GLP-1
  • Incretin hormones
  • Incretin-based therapy
  • Osteoporosis
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Ceccarelli, E., Guarino, E. G., Merlotti, D., Patti, A., Gennari, L., Nuti, R., & Dotta, F. (2013). Beyond glycemic control in diabetes mellitus: Effects of incretin-based therapies on bone metabolism. Frontiers in Endocrinology, 4(JUN), [Article 73]. https://doi.org/10.3389/fendo.2013.00073

Beyond glycemic control in diabetes mellitus : Effects of incretin-based therapies on bone metabolism. / Ceccarelli, Elena; Guarino, Elisa G.; Merlotti, Daniela; Patti, Aurora; Gennari, Luigi; Nuti, Ranuccio; Dotta, Francesco.

In: Frontiers in Endocrinology, Vol. 4, No. JUN, Article 73, 2013.

Research output: Contribution to journalArticle

Ceccarelli, E, Guarino, EG, Merlotti, D, Patti, A, Gennari, L, Nuti, R & Dotta, F 2013, 'Beyond glycemic control in diabetes mellitus: Effects of incretin-based therapies on bone metabolism', Frontiers in Endocrinology, vol. 4, no. JUN, Article 73. https://doi.org/10.3389/fendo.2013.00073
Ceccarelli, Elena ; Guarino, Elisa G. ; Merlotti, Daniela ; Patti, Aurora ; Gennari, Luigi ; Nuti, Ranuccio ; Dotta, Francesco. / Beyond glycemic control in diabetes mellitus : Effects of incretin-based therapies on bone metabolism. In: Frontiers in Endocrinology. 2013 ; Vol. 4, No. JUN.
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