How Do GLP-1 Levels Relate to Osteoporosis in Postmenopausal Women?

High GLP-1 levels were associated with reduced risk for osteoporosis in postmenopausal women.

Postprandial glucagon-like peptide-1 (GLP-1) levels are significantly lower in postmenopausal women with osteoporosis, and high GLP-1 levels are associated with reduced risk for osteoporosis, according to study results published in Scientific Reports.

Intestinal peptides GLP-1 and GLP-2 are involved in regulating digestion and have been investigated for their roles in other metabolism pathways, including a functional relationship between intestine and bone metabolism.

As there is limited evidence for the relationship between osteoporosis and GLP-1 in people without diabetes, the goal of this study was to explore the association of postprandial plasma levels of GLP-1 and GLP-2, as well as dipeptidyl peptidase 4, with osteoporosis in postmenopausal women who do not have diabetes.

The case-control study included postmenopausal women aged <70 years with and without osteoporosis, matched 1:1 by age. All cases of osteoporosis were diagnosed previously by dual-energy x-ray absorptiometry scans. The control group included postmenopausal women who did not have diabetes, osteoporosis on dual-energy x-ray absorptiometry, or history of low-energy fracture.

Postprandial GLP-1 levels (± standard error of the mean) were significantly lower in the group with osteoporosis (116.75±2.68 pg/mL) compared with the control group (126.79±2.68; P <.001).

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There was a significant association between GLP-1 and a reduction in osteoporosis risk in the crude (odds ratio, 0.724; 95% CI, 0.53-0.97; P =.031) and adjusted analyses (odds ratio, 0.603; 95% CI, 0.38-0.94; P =.027).

No statistically significant between-group differences were found in plasma GLP-2 or dipeptidyl peptidase 4 levels.

The main study limitation was that only one analytic determination of peptides and bone markers was completed.  

The researchers concluded that their results “suggest that [GLP-1] analog molecules, currently prescribed for diabetes mellitus, may potentially represent an alternative therapeutic approach to osteoporosis.”

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Montes Castillo MC, Martínez Ramírez MJ, Soriano Arroyo R, et al. Glucagon-like peptide 1 and glucagon-like peptide 2 in relation to osteoporosis in non-diabetic postmenopausal women. Sci Rep. 2019;9:13651.