Energy Regulation by the Skeleton

Life relies on the integration of external environmental stimuli and internal signals to balance fluctuations in nutrient availability to achieve homeostasis. Bone has recently emerged as a pleiotropic endocrine organ that secretes at least two hormones, FGF23 and osteocalcin, which regulate kidney function and glucose homeostasis, respectively. These findings have raised the question of whether other bone-derived hormones exist and what their potential functions are. Here we identify, through molecular and genetic analyses in mice, lipocalin 2 (LCN2) as an osteoblast-enriched, secreted protein. Loss- and gain-of-function experiments in mice demonstrate that osteoblast-derived LCN2 maintains glucose homeostasis by inducing insulin secretion and improves glucose tolerance and insulin sensitivity. In addition, osteoblast-derived LCN2 inhibits food intake. LCN2 crosses the blood–brain barrier, binds to the melanocortin 4 receptor (MC4R) in the paraventricular and ventromedial neurons of the hypothalamus and activates an MC4R-dependent anorexigenic (appetite-suppressing) pathway. These results identify LCN2 as a bone-derived hormone with metabolic regulatory effects, which suppresses appetite in a MC4R-dependent manner, and show that the control of appetite is an endocrine function of bone. Furthermore, we show that serum LCN2 levels correlate with insulin levels and β-cell function, indices of healthy glucose metabolism, in genetic and diet-induced mouse models of obesity and in obese, healthy or pre-diabetic patients. However, LCN2 serum levels also correlate with body mass index (BMI) and insulin resistance in the same patients; and are increased in obese mice. To dissect this apparent discrepancy, we examined LCN2 effects in hyperphagia and β -cell function mouse models of obesity or β -cell destruction. Silencing Lcn2 expression increases hyperphagia, fat and body weight and worsens β -cell function and general metabolic dysfunction in obese, leptin receptor-deficient mice. Conversely, LCN2 increases β-cell numbers and promotes β-cell function after streptozotocin-induced β -cell failure by (STZ) and acts as a growth factor necessary for β -cell adaptation to higher metabolic load in mice. These results support a protective role for LCN2 in obesity-induced glucose intolerance and insulin resistance that stem from its ability to decrease food intake and promote adaptive β-cell proliferation.