Conversations Between Insulin and Bone: Potential Mechanism Of High Bone Density in Patients with Berardinelli-Seip Congenital Lipodystrophy

• Published in: Medical hypotheses Vol. 97; pp. 94 - 97
• Main Authors: Gomes Lima, Josivan, Nobrega Lima, Natalia, Helena C Nobrega, Lucia, Maria B Jeronimo, Selma
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01-12-2016
• Subjects: Adipose Tissue; Body Mass Index; Bone and Bones - metabolism; Bone Density; Bone mass; Density; Homeostasis; Humans; Hyperinsulinism - metabolism; Insulin; Insulin - metabolism; Insulin Resistance; Internal Medicine; Leptin; Leptin - blood; Leptin - metabolism; Lipodystrophy; Lipodystrophy, Congenital Generalized - diagnosis; Lipodystrophy, Congenital Generalized - pathology; Mutation; Vitamin D - metabolism; bone mass; insulin; density; leptin; lipodystrophy; Lipodystrophy; Bone mass; Insulin; Density; Leptin
• ISSN: 0306-9877; 1532-2777
• DOI: 10.1016/j.mehy.2016.10.025

Abstract Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty storing lipid in adipocytes, low body fat, hypertriglyceridemia, and fat liver. The serum leptin is usually very low, and serum insulin, as well as HOMAIR (homeostasis model assessment), is very high and correlated positively with bone mineral density (BMD). Despite deficiency/insufficiency of vitamin D, low body mass index, low daily calcium intake, physical inactivity, and menarche at a later age, BSCL patients usually have normal or even high BMD. We hypothesize that low leptin and high insulin may play a role in this outcome. Understanding the potential pathophysiological mechanism of these bone abnormalities will help to clarify the effects of extreme insulin resistance in the bone.