Abstract:The relationship between gut and skeleton is increasingly recognized as part of the integrated physiology of the whole organism. The incretin hormones gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) are secreted from the intestine in response to nutrient intake and exhibit several physiological functions including regulation of islet hormone secretion and glucose levels. A number of GLP-1 receptor agonists (GLP-1RAs) are currently used in treatment of type 2 diabetes and obesity. However, GIP and GLP-1 cognate receptors are widely expressed suggesting that incretin hormones mediate effects beyond control of glucose homeostasis, and reports on associations between incretin hormones and bone metabolism have emerged. The aim of this MiniReview was to provide an overview of current knowledge regarding the in vivo and in vitro effects of GIP and GLP-1 on bone metabolism. We identified a total of 30 pre-clinical and clinical investigations of the effects of GIP, GLP-1 and GLP-1RAs on bone turnover markers, bone mineral density (BMD), bone microarchitecture and fracture risk. Studies conducted in cell cultures and rodents demonstrated that GIP and GLP-1 play a role in regulating skeletal homeostasis, with preclinical data suggesting that GIP inhibits bone resorption whereas GLP-1 may promote bone formation and enhance bone material properties. These effects are not corroborated by clinical studies. While there is evidence of effects of GIP and GLP-1 on bone metabolism in pre-clinical investigations, clinical trials are needed to clarify whether similar effects are present and clinically relevant in humans.Bone remodelling is the regenerative mechanism that maintains the skeletal health and biomechanical competence through resorption of bone by osteoclasts and formation of new bone by osteoblasts. These processes are highly co-ordinated and under the influence of several hormonal factors [1].Incretin hormones encompass a group of hormones characterized by their ability to enhance insulin secretion in response to intake of nutrients, such as glucose and fat. The most important incretin hormones are gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) [2]. Both of these hormones interact with cognate receptors, which are widely expressed in human tissues: the GIP receptor (GIPR) is expressed in pancreas, central nervous system, thyroid as well as adipose tissue [3], and the GLP-1 receptor (GLP-1R) is expressed in the kidney, stomach, duodenum, central nervous system and pancreas [4]. Both the GIP and the GLP-1 receptors are 7-transmembrane proteins, and activation of these receptors by binding of either GIP or GLP-1 increases intracellular levels of cyclic adenosine monophosphate (cAMP) and Ca 2+ [5].Gastric inhibitory polypeptide and GLP-1 are secreted from enteroendocrine cells of the small intestine. Once secreted, GLP-1 binds to the GLP-1 receptors expressed on pancreatic b-cells, leading to a glucose-dependent insulin secretion but the effect is short-lived as GLP...