Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;88(1):348-358.
doi: 10.1007/s12020-024-04140-4. Epub 2024 Dec 30.

Bone and muscle mass characteristics in patients with gastroenteropancreatic neuroendocrine neoplasms

Charalampos Aktypis  1 , Maria P Yavropoulou  2 , Efstathios Efstathopoulos  3 , Despina Polichroniadi  3 , Kalliopi Anna Poulia  4 , George Papatheodoridis  5 , Gregory Kaltsas  2
Affiliations

Bone and muscle mass characteristics in patients with gastroenteropancreatic neuroendocrine neoplasms

Charalampos Aktypis et al. Endocrine. 2025 Apr.

Abstract

Background: Neuroendocrine neoplasms (NEN) are rare tumors arising from neuroendocrine cells most commonly in the gastrointestinal-tract. In recent years, advancements in therapeutics have increased survival rates in patients with NEN leading to a greater clinical burden compared to the general population.

Methods: The aim of this single-center case-control study was to investigate the incidence of low bone mass and changes in body composition in adult patients diagnosed with gastroenteropancreatic neuroendocrine tumors (GEPNET). Enrolled participants underwent measurements of bone mineral density (BMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) and body composition analysis with calculation of total fat-mass (TFM) and relative skeletal mass index (RSMI), by dual X-ray absorptiometry.

Results: Ninety GEPNET patients (28 with Pancreatic-NET, 20 with small-intestine-NET, 42 with gastric-NET), and 50 age and sex-matched controls were enrolled. The mean disease duration was 5±4.4 years, the majority of patients (54/90) was classified as stage-1, and were not receiving systemic-treatment (76/90). The incidence of osteoporosis/osteopenia was threefold higher in the patients' cohort, compared to controls (OR: 3.17 95% CI 1.16-7.8, p < 0.001). Among NEN patients, gastric-NET had the lowest bone mass, especially in LS. In addition, GEPNET patients demonstrated significantly lower TFM and RSMI, compared to controls (TFM: 31.6 ± 9.6 kg vs. 38.6 ± 6.4 kg, respectively, p = 0.03; RSMI: 6.4 ± 1.1 vs. 8.2 ± 0.6, respectively, p < 0.001). Within our patients' cohort, RSMI was significantly associated with LS-BMD (rho = 0.49, p < 0.001) and TH-BMD (rho = 0.58, p < 0.001), and TFM was associated with TH-BMD (rho = 0.31, p = 0.004).

Conclusions: Patients with GEPNET even at an early stage exhibit significantly lower bone, muscle and fat mass compared to the non-NET population, highlighting the importance of continuous monitoring of the musculoskeletal system in these patients.

Keywords: dual x-ray absorptiometry; gastroenteropancreatic neuroendocrine tumors; lipodystrophy; osteoporosis; sarcopenia; somatostatin analogs.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. J. Hofland, G. Kaltsas, W.W. de Herder, Advances in the diagnosis and management of well-differentiated neuroendocrine neoplasms. Endocr Rev 41(2), 371–403 (2020) - PubMed - PMC
    1. G. Rindi, O. Mete, S. Uccella, O. Basturk, S. La Rosa, L.A.A. Brosens, S. Ezzat, W.W. de Herder, D.S. Klimstra, M. Papotti, S.L. Asa, Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms. Endocr Pathol 33(1), 115–154 (2022). https://doi.org/10.1007/s12022-022-09708-2 . - DOI - PubMed
    1. J. Pobłocki, A. Jasińska, A. Syrenicz, E. Andrysiak-Mamos, M. Szczuko, The neuroendocrine neoplasms of the digestive tract: diagnosis, treatment and nutrition. Nutrients 12(5), 1437 (2020). https://doi.org/10.3390/nu12051437 . - DOI - PubMed - PMC
    1. A. Dasari, C. Shen, D. Halperin, B. Zhao, S. Zhou, Y. Xu, T. Shih, J.C. Yao, Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 3(10), 1335–1342 (2017) - PubMed - PMC
    1. M. Falconi, B. Eriksson, G. Kaltsas, D.K. Bartsch, J. Capdevila, M. Caplin, B. Kos-Kudla, D. Kwekkeboom, G. Rindi, G. Klöppel, N. Reed, R. Kianmanesh, R.T. Jensen, ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors. Neuroendocrinology 103(2), 153–171 (2016) - PubMed

MeSH terms

Supplementary concepts

LinkOut - more resources