A single dose of prednisolone suppresses bone remodelling markers and impairs insulin sensitivity at rest and after exercise — ASN Events
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A single dose of prednisolone suppresses bone remodelling markers and impairs insulin sensitivity at rest and after exercise (#176)

Lewan Parker 1 , Andrew Garnham 1 , Glenn McConell 1 , Nigel Stepto 1 , David L Hare 2 , Elizabeth Byrnes 3 , Peter Ebeling 4 , Ego Seeman 5 , Tara Brennan-Speranza 6 , Itamar Levinger 1
  1. Victoria University, Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
  2. Cardiology, Austin Health, Melbourne, VIC, Australia
  3. PathWest , QEII Medical Centre, Perth, WA, Australia
  4. Department of Medicine, Monash University, Melbourne, VIC, Australia
  5. Endocrinology, Austin Health, Melbourne, VIC, Australia
  6. Bosch Institute for Medical Research, University of Sydney, Sydney, NSW, Australia

Background: Glucocorticoid (GC) treatment impairs bone formation, undercarboxylated osteocalcin (ucOC) and insulin sensitivity. Acute exercise increases bone remodelling markers (BRMs), ucOC and improves insulin sensitivity. We investigated whether attenuation of ucOC using a single dose of prednisolone (Pred) is associated with impaired resting (basal) and post-exercise insulin sensitivity in healthy males.

Methods: Nine healthy males (Age: 28 ± 2 years; BMI: 24 ± 1; Mean ± SEM) were randomly allocated in a double-blinded cross-over design to receive a single dose of either 20 mg of Pred or placebo, ∼7 days between trials. Capsules were taken in the evening prior each trial day. Twelve hours later, after an overnight fast, participants performed a session of high-intensity interval exercise. Basal insulin resistance was estimated using the homeostatic model assessment (HOMA2-IR) and post-exercise insulin sensitivity was assessed via euglycaemic hyperinsulinaemic clamp (EHC) which was commenced 3 hours post-exercise. Serum osteocalcin (OC), ucOC, procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (β-CTX) were measured.

Results: Resting (basal): compared with placebo, Pred decreased resting OC, P1NP and ucOC (-22 to -39%, p<0.01), with no change in β-CTX, and increased basal HOMA2-IR (107±27%, p<0.001). Higher OC and ucOC levels were correlated with lower HOMA2-IR (r=-0.45, p=0.06 and r=-0.54, p=0.02, respectively). Exercise: exercise increased (p<0.05) ucOC similarly in the two trials (Pred: 12%; placebo: 13%, p=0.74). ucOC remained lower in Pred than placebo (7.0±0.4 vs. 9.5±0.8 ng/ml, p<0.001). Post exercise insulin sensitivity was lower in Pred than placebo (-34±5%, p<0.001). Post-exercise insulin sensitivity correlated with basal OC (r=0.66, p<0.01) and ucOC (r=0.72, p<0.01).

Conclusions: The negative effect of Pred on insulin sensitivity at rest and following exercise are related, at least in part, to suppression of OC and ucOC.