Purpose

The aim was to examine changes in the bone-derived hormone lipocalin 2 (LCN2) levels in patients with active acromegaly and to investigate the potential roles of LCN2 and osteocalcin in glucose metabolism.

Methods

We recruited 50 consecutive acromegalic patients. Of those, 39 patients with complete postoperative follow-up data were included. Thirty sex-, age-, and BMI-matched healthy individuals were recruited as normal controls. The pre- and postoperative serum LCN2 and osteocalcin levels were compared. The homeostasis model assessment insulin resistance (HOMA-IR) index and secretion [β-cell function (HOMA-β)] were calculated.

Results

Compared with controls, acromegalic subjects had lower LCN2 levels (34.15 ± 9.95 vs 57.50 ± 29.75 ng/mL, P < 0.01) and higher osteocalcin levels (55.45 ± 34.02 vs 19.46 ± 6.69 ng/mL, P < 0.01). Acromegalic patients also had elevated HOMA-IR levels, and the HOMA-β and the area under the curve for insulin (AUC INS) levels were slightly but nonsignificantly increased. The serum levels of LCN2 significantly increased after surgery (37.03 ± 9.73 vs 45.15 ± 15.33 ng/mL, P < 0.05), and those of osteocalcin significantly decreased [43.51 (26.73–65.66) vs 24.79 (18.39–32.59) ng/mL, P < 0.01]. Total lean mass was the only positive predictor of LCN2, and elevated serum IGF-I was a positive predictor of osteocalcin. Low LCN2 and elevated serum osteocalcin levels were predictors of the AUC INS, and osteocalcin was a positive predictor of HOMA-β.

Conclusion

The bone-derived hormones, osteocalcin and LCN2 changed significantly in active acromegaly, were altered after treatment and served as predictors of β-cell function in acromegaly. This study shows that the bone could be involved in regulating glucose metabolism in acromegaly.

中文翻译：

---

肢端肥大症中循环骨源激素lipocalin 2，骨钙素和葡萄糖代谢之间的关联。

目的

目的是研究活跃肢端肥大症患者的骨源性激素lipocalin 2（LCN2）水平的变化，并研究LCN2和骨钙素在葡萄糖代谢中的潜在作用。

方法

我们连续招募了50名肢端肥大症患者。其中，39例术后随访资料完整。招募了三十名性别，年龄和体重指数匹配的健康个体作为正常对照。比较术前和术后血清LCN2和骨钙素水平。计算稳态模型评估的胰岛素抵抗（HOMA-IR）指数和分泌物[β细胞功能（HOMA-β）]。

结果

与对照组相比，肢端肥大症患者的LCN2水平较低（34.15±9.95 vs 57.50±29.75 ng / mL，P  <0.01）和骨钙素水平较高（55.45±34.02 vs 19.46±6.69 ng / mL，P  <0.01）。肢端肥大症患者的HOMA-IR水平也升高，并且HOMA-β和胰岛素曲线下面积（AUC INS）略有增加，但无明显增加。术后LCN2的血清水平显着升高（37.03±9.73 vs 45.15±15.33 ng / mL，P  <0.05），而骨钙素水平显着降低[43.51（26.73–65.66）vs 24.79（18.39–32.59）ng / mL，P <0.01]。总瘦体重是LCN2的唯一阳性指标，而血清IGF-I升高则是骨钙素的阳性指标。LCN2低和血清骨钙素水平升高是AUC INS的预测因子，而骨钙素是HOMA-β的阳性预测因子。

结论

骨骼肌激素，骨钙素和LCN2在活跃的肢端肥大症中发生了显着变化，在治疗后发生了变化，可作为肢端肥大症中β细胞功能的预测指标。这项研究表明，骨骼可能参与了肢端肥大症的葡萄糖代谢调节。