Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours?. (29th July 2013)

• Record Type: Journal Article
• Authors: Sen Gupta, Piya; Grozinsky‐Glasberg, Simona; Drake, William M.; Akker, Scott A.; Perry, Les; Grossman, Ashley B.; Druce, Maralyn R.
• Is Part Of: Clinical endocrinology. Volume 80:Number 2(2014:Feb.)
• Page Start: 246
• Page End: 252
• Publication Date: 2013-07-29
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12270
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12270-abs-0001"> <title>Summary</title> <sec id="cen12270-sec-0001" sec-type="section"> <title>Background</title> <p>Bone mineral density (BMD) is influenced by multiple factors. Recent studies have highlighted a possible relationship between serotonin and BMD. Patients with neuroendocrine tumours (NETs) frequently have elevated urinary 5‐hydroxy‐indoleacetic acid (5‐HIAA) levels, a serotonin metabolite. Evaluation of the relationship between 5‐HIAA and BMD in patients with NETs may provide insights into the relationship between serotonin and BMD.</p> </sec> <sec id="cen12270-sec-0002" sec-type="section"> <title>Methods</title> <p>One‐year audit of consecutive patients with NETs within two institutions. Relationships between urinary 5‐HIAA and dual X‐ray absorptiometry (DEXA)‐scan‐measured BMD were investigated by group comparisons, correlation and regression.</p> </sec> <sec id="cen12270-sec-0003" sec-type="section"> <title>Results</title> <p>Of 65 patients with NETs, 19 did not participate or were excluded. Of 46 subjects evaluated (48·9% males, 63·8 ± 10·5 years, BMI 26·6 ± 4·4 kg/m<sup>2</sup>) with 32 gastrointestinal, 9 pancreatic, 3 pulmonary and 2 ovarian NETs, 72·3% had the carcinoid syndrome. Median interval from diagnosis was 4·0 years (IQR 2·0–6·0); 41·3% had osteoporosis and 32·6% osteopaenia (WHO definition). The group with a higher urinary 5‐HIAA had a lower hip BMD (total T‐score and Z‐score), confirmed on individual analysis (Spearman's rank correlation −0·41, <italic>P</italic> = 0·004; −0·44, <italic>P</italic> = 0·002, respectively); urinary 5‐HIAA was not found to be an independent predictor for BMD on multiple linear regression analysis.</p> </sec> <sec id="cen12270-sec-0004" sec-type="section"> <title>Conclusion</title> <p>These data of patients with NETs with higher serotonin metabolites having a lower BMD at the hip in group and individual comparisons, warrants further evaluation. Urinary 5‐HIAA measurement alone cannot be used to predict future BMD. A larger cohort with prospective design including fractures as a clinical outcome will aid these data in determining whether patients with NETs should be subject to targeted osteoporosis prevention.</p> </sec> </abstract>