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Association between changes in bioactive osteocalcin and glucose homeostasis after biliopancreatic diversion

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Abstract

Purpose

Bone may regulate glucose homeostasis via uncarboxylated bioactive osteocalcin (ucOCN). This study explored whether changes in ucOCN and bone remodeling are associated with change in glucose homeostasis after biliopancreatic diversion (BPD).

Methods

In this secondary exploratory analysis of a 1-year prospective observational study, 16 participants (11 men/5 women; 69% with type 2 diabetes; mean BMI 49.4 kg/m2) were assessed before, 3 days, 3 months and 12 months after BPD. Changes in plasma ucOCN and bone markers (C-terminal telopeptide (CTX), total osteocalcin (OCN)) were correlated with changes in insulin resistance or sensitivity indices (HOMA-IR; adipose tissue insulin resistance index (ADIPO-IR) and insulin sensitivity index (SI) from the hyperinsulinemic-euglycemic clamp), insulin secretion rate (ISR) from the hyperglycemic clamp, and disposition index (DI: SI × ISR) using Spearman correlations before and after adjustment for weight loss.

Results

ucOCN was unchanged at 3 days but increased dramatically at 3 months (+257%) and 12 months (+498%). Change in ucOCN correlated significantly with change in CTX at 3 months (r = 0.62, p = 0.015) and 12 months (r = 0.64, p = 0.025) before adjustment for weight loss. It also correlated significantly with change in fasting insulin (r = −0.53, p = 0.035), HOMA-IR (r = −0.54, p = 0.033) and SI (r = 0.52, p = 0.041) at 3 days, and ADIPO-IR (r = −0.69, p = 0.003) and HbA1c (r = −0.69, p = 0.005) at 3 months. Change in OCN did not correlate with any glucose homeostasis indices. Results were similar after adjustment for weight loss.

Conclusion

The increase in ucOCN may be associated with the improvement in insulin resistance after BPD, independently of weight loss. These findings need to be confirmed in larger, less heterogeneous populations.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank M. David Simonyan for his help with statistical analyses.

Funding

The Canadian Institutes of Health Research (MOP 97947 & MOP 133652), Canadian Diabetes Association (NC-3-17-5232-CG) and CHU de Québec-Université Laval Foundation provided funding for this research. AMC is the recipient of Fonds de recherche du Québec-Santé (FRQ-S) and Diabetes Canada scholarships. MF holds the Canada Research Chair in Bone and Energy Metabolism. FM has a scholarship from FRQ-S and is a co-Chair of the Amgen Research Chair in Nephrology from Université Laval Foundation. CG is a clinical research scholar of the FRQ-S and the recipient of a Diabetes Canada New Investigator Award.

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Authors and Affiliations

  1. Endocrinology and Nephrology Unit, CHU de Québec—Université Laval Research Centre, Québec City, QC, Canada

    Anne-Frédérique Turcotte, Anne-Marie Carreau, Fabrice Mac-Way, André Tchernof & Claudia Gagnon

  2. Department of Medicine, Laval University, Québec City, QC, Canada

    Anne-Frédérique Turcotte, Anne-Marie Carreau, Fabrice Mac-Way, André Tchernof, Denis Richard & Claudia Gagnon

  3. Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada

    Thomas Grenier-Larouche & André C. Carpentier

  4. Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada

    Thomas Grenier-Larouche & André C. Carpentier

  5. Institut de recherches cliniques de Montréal, Montreal, QC, Canada

    Julie Lacombe & Mathieu Ferron

  6. Québec Heart and Lung Institute Research Centre, Québec City, QC, Canada

    André Tchernof, Denis Richard, Laurent Biertho, Stefane Lebel, Simon Marceau & Claudia Gagnon

  7. Department of Surgery, Laval University, Québec City, QC, Canada

    Laurent Biertho, Stefane Lebel & Simon Marceau

  8. Department of Medicine, Université de Montréal, Montreal, QC, Canada

    Mathieu Ferron

  9. Institute of Nutrition and Functional Foods, Université Laval, Quebec City, QC, Canada

    Claudia Gagnon

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  1. Anne-Frédérique Turcotte
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Contributions

A.F.T. and C.G. contributed to the study conception and design. Material preparation, data collection and analysis were performed by A.F.T., T.G.L., J.L., A.C.C., M.F. and C.G. The first draft of the paper was written by A.F.T. and all authors commented on previous versions of the paper. All authors read and approved the final paper.

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Correspondence to Claudia Gagnon.

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Conflict of interest

A.M.C. receives consultation honoraria from Pfizer. A.C.C. is the recipient of the Canada Research Chair in Molecular Imaging of Diabetes. A.T. and L.B. receive funding from Johnson Johnson Medical Companies and Medtronic for research studies on bariatric surgery. M.F. receives royalties from BioLegend for the development of the ucOCN ELISA assay. T.G.L. is now a full-time employee of Boehringer Ingelheim Canada. F.M. received speaker honoraria from Amgen and Sanofi, and participated in advisory committee for Otsuka. C.G. received research funding from Shire and speaker honoraria from Amgen, Eli Lilly and Janssen.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institut Universitaire de cardiologie et de pneumologie de Québec (IUCPQ) ethical review board.

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Informed consent was obtained for all participants before entering the study.

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Turcotte, AF., Grenier-Larouche, T., Lacombe, J. et al. Association between changes in bioactive osteocalcin and glucose homeostasis after biliopancreatic diversion. Endocrine 69, 526–535 (2020). https://doi.org/10.1007/s12020-020-02340-2

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