Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 25 P3

Bone

Evaluation of the association between serotonin and bone mineral density in patients with neuroendocrine tumours

Piya Sen Gupta, William M Drake, Scott A Akker, Shern L Chew, Ashley B Grossman & Maralyn R Druce


Barts and the London School of Medicine, QMUL, London, UK.


Introduction: Bone mineral density (BMD) and fracture tendency are influenced by diet, activity, drugs, and hormones. Recent studies highlight an inverse relationship between serotonin and BMD, of uncertain mechanism.

Purpose: We investigated the relationship between serotonin metabolites and BMD in patients with sporadic neuroendocrine tumours (NETs), with and without the carcinoid syndrome.

Materials and methods: One-year prospective audit [ref 09/104]. All patients underwent DEXA-scanning as standard care for chronic malignancy. Data collection included clinical details, confounders influencing BMD and relevant investigation results.

Results: Of 41 eligible patients, 15 did not participate (too unwell, defaulted follow-up, declined participation) and 3 were excluded due to confounding factors. Twenty-three subjects were reviewed (15 females, 59.9±19 years, BMI 26.8±5.6, 8 males, 69.0±3.0 years BMI 30.6±5.6). The mean interval since diagnosis was 5.7 years (range 0–20 years); 16 had carcinoid syndrome, 7 did not. Thirteen had previous surgery, 4 chemotherapy, 11 radiolabelled-MIBG and 14 used somatostatin analogues.

Low BMD was not prominent: only 4 subjects had Z score >1 S.D. below the mean, with no unifying features in this group. 10 subjects had T score ≤−1.0 (osteopaenia or osteoporosis), all were females (P<0.01), and 7 had the carcinoid syndrome (P>0.05). Mean BMI was 25.4 cf 30.2 for those with normal T-score (P<0.05). The low T-score group did not differ from the group with a normal T-score in age, smoking, alcohol, medications, calcium or TSH but mean vitamin D was higher (77.8 vs 48.6 nmol/l; P=0.05). There was no difference in chromogranin-A (217.9 vs 281.9 pmol/l, P=0.6) or urine 5HIAA (360.8 vs 147.5 μmol/24 h, P=0.3). Z-scores did not differ between subjects with elevated or normal 5HIAA (P=0.28) or between subjects with and without the carcinoid syndrome (P=0.38).

Conclusion: NET patients do not show lower BMD related to serotonin metabolites or disease markers, although a larger cohort is required for confirmation of these preliminary data.

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