Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours?
BACKGROUND: 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 metabolit...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2014
|
| _version_ | 1797070397037871104 |
|---|---|
| author | Sen Gupta, P Grozinsky-Glasberg, S Drake, WM Akker, SA Perry, L Grossman, AB Druce, MR |
| author_facet | Sen Gupta, P Grozinsky-Glasberg, S Drake, WM Akker, SA Perry, L Grossman, AB Druce, MR |
| author_sort | Sen Gupta, P |
| collection | OXFORD |
| description | BACKGROUND: 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. METHODS: 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. RESULTS: 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(2) ) 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, P = 0·004; -0·44, P = 0·002, respectively); urinary 5-HIAA was not found to be an independent predictor for BMD on multiple linear regression analysis. CONCLUSION: 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. |
| first_indexed | 2024-03-06T22:38:13Z |
| format | Journal article |
| id | oxford-uuid:5aa6cf6a-8b34-44e0-9ab3-65bf865924ef |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:38:13Z |
| publishDate | 2014 |
| record_format | dspace |
| spelling | oxford-uuid:5aa6cf6a-8b34-44e0-9ab3-65bf865924ef2022-03-26T17:17:04ZAre serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5aa6cf6a-8b34-44e0-9ab3-65bf865924efEnglishSymplectic Elements at Oxford2014Sen Gupta, PGrozinsky-Glasberg, SDrake, WMAkker, SAPerry, LGrossman, ABDruce, MRBACKGROUND: 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. METHODS: 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. RESULTS: 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(2) ) 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, P = 0·004; -0·44, P = 0·002, respectively); urinary 5-HIAA was not found to be an independent predictor for BMD on multiple linear regression analysis. CONCLUSION: 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. |
| spellingShingle | Sen Gupta, P Grozinsky-Glasberg, S Drake, WM Akker, SA Perry, L Grossman, AB Druce, MR Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title | Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title_full | Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title_fullStr | Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title_full_unstemmed | Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title_short | Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours? |
| title_sort | are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours |
| work_keys_str_mv | AT senguptap areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT grozinskyglasbergs areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT drakewm areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT akkersa areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT perryl areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT grossmanab areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours AT drucemr areserotoninmetabolitelevelsrelatedtobonemineraldensityinpatientswithneuroendocrinetumours |