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Are serotonin metabolite levels related to bone mineral density in patients with neuroendocrine tumours?
Author(s) -
Sen Gupta Piya,
GrozinskyGlasberg Simona,
Drake William M.,
Akker Scott A.,
Perry Les,
Grossman Ashley B.,
Druce Maralyn R.
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12270
Subject(s) - bone mineral , medicine , endocrinology , serotonin , carcinoid syndrome , urinary system , osteoporosis , gastroenterology , metabolite , receptor
Summary 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 ( NET s) 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 NET s may provide insights into the relationship between serotonin and BMD . Methods One‐year audit of consecutive patients with NET s 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 NET s, 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 NET s, 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 NET s 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 NET s should be subject to targeted osteoporosis prevention.