Skeletal health in long-duration astronauts: Nature, assessment, and management recommendations from the NASA Bone Summit

Journal of Bone and Mineral Research

Volumn 28, Issue 6, 2013, Pages 1243-1255

  Orwoll, Eric S ^a   Adler, Robert A ^b   Amin, Shreyasee ^c   Binkley, Neil ^d   Lewiecki, E Michael ^e   Petak, Steven M ^f   Shapses, Sue A ^g   Sinaki, Mehrsheed ^c   Watts, Nelson B ^h   Sibonga, Jean D ⁱ  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

^b VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c MAYO CLINIC   (United States)

^d UNIVERSITY OF WISCONSIN MADISON   (United States)

^e NEW MEXICO CLINICAL RESEARCH AND OSTEOPOROSIS CENTER   (United States)

^f Texas Institute for Reproductive Medicine and Endocrinology   (United States)

^g RUTGERS UNIVERSITY   (United States)

^h Mercy Health Osteoporosis and Bone Health Services   (United States)

ⁱ NASA JOHNSON SPACE CENTER   (United States)

Author keywords

DXA; FINITE ELEMENT MODELING; FRACTURE; MICROGRAVITY; OSTEOPOROSIS; QCT; SPACEFLIGHT

Indexed keywords

BONE DENSITY; BONE STRENGTH; BONE TURNOVER; CLINICAL ARTICLE; COMPUTER ASSISTED TOMOGRAPHY; COSMONAUT; DUAL ENERGY X RAY ABSORPTIOMETRY; FEMUR NECK; HUMAN; LONG TERM EXPOSURE; LUMBAR SPINE; MICROGRAVITY; OSTEOLYSIS; REVIEW; RISK ASSESSMENT; SPACE FLIGHT;

ABSORPTIOMETRY, PHOTON; AEROSPACE MEDICINE; ASTRONAUTS; BONE AND BONES; BONE DISEASES; FEMALE; HUMANS; MALE; NEEDS ASSESSMENT; TIME FACTORS; UNITED STATES; UNITED STATES NATIONAL AERONAUTICS AND SPACE ADMINISTRATION; WEIGHTLESSNESS;

EID: 84878248811     PISSN: 08840431     EISSN: 15234681     Source Type: Journal    
DOI: 10.1002/jbmr.1948     Document Type: Review

References (39)

1. LeBlanc A, Shackelford L, Schneider V., Future human bone research in space. Bone. 1998; 22 (5): 113S-6S.
2. Adams GR, Caiozzo VJ, Baldwin KM., Skeletal muscle unweighting: spaceflight and ground-based models. J Appl Physiol. 2003; 95: 2185-201.
3. Cavanagh PR, Licata AA, Rice AJ., Exercise and pharmacological countermeasures for bone loss during long-duration space flight. Gravit Space Biol Bull. 2005; 18 (2): 39-58.
4. LeBlanc AD, Spector ER, Evans HJ, Sibonga JD., Skeletal responses to spaceflight and the bed rest analog: a review. Musculoskelet Neuronal Interact. 2007; 7 (1): 33-47.
5. Zwart SR, Smith SM., Impact of space flight on the human skeletal system and potential nutritional countermeasures. Int SportMed J. 2005; 4: 199-214.
6. Pietrzyk RA, Jones JA, Sams CF, Whitson PA., Renal stone formation among astronauts. Aviat Space Environ Med. 2007; 78 (4 Suppl): A9-13.
7. Smith SM, Zwart SR., Nutritional biochemistry of spaceflight. Adv Clin Chem. 2008; 46: 87-13.
8. Payne MWC, William DR, Trudel G., Space flight rehabilitation: literature review. Am J Phys Med Rehabil. 2007; 86 (1): 1-9.
9. Whedon GD, Lutwak L, Rambaut P, Whittle M, Leach C, Reid J, Smith M., Effect of weightlessness on mineral metabolism; metabolic studies on Skylab orbital spaceflights. Calcif Tissue Res. 1976; 21 (Suppl): 423-30.
10. Rambaut PC, Johnston RS., Prolonged weightlessness and calcium loss in man. Acta Astronaut. 1979; 6 (9): 1113-22.
11. LeBlanc A, Schneider V, Shackelford L, West S, Oganov V, Bakulin A, Voronin L., Bone mineral and lean tissue loss after long-duration spaceflight. J Musculoskelet Neuronal Interact. 2000; 1 (2): 157-60.
12. U.S. Occupational Safety and Health Administration. Basic Program Elements for Federal Employee Occupational Safety and Health Programs, 29 Code of Federal Regulations (CFR) Part 1960 (1995). Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration [cited 2013 Apr 7]. Available from: http://www.osha.gov/pls/oshaweb/owastand.display-standard-group? p-toc-level1/41&p-part-number1/41960.
13. National Aeronautics and Space Administration (US). Space flight human system standard. Washington DC: National Aeronautics and Space Administration (US); 2007. (NASA publication; no. NASA-STD-3001). Vol 1. Crew health.
14. Smith SM, Heer MA, Shackelford L, Sibonga JD, Ploutz-Snyder L, Zwart SR., Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: evidence from biochemistry and densitometry. J Bone Miner Res. 2012; 27 (9): 1-11.
15. Sibonga JD, Evans HJ, Sung HG, Spector ER, Lang TF, Oganov VS, Bakulin AV, Shackelford LC, LeBlanc AD., Recovery of spaceflight-induced bone loss: bone mineral density after long-duration missions as fitted with an exponential function. Bone. 2007; 41 (6): 973-8.
16. NIH. Consensus Development Panel on Osteoporosis Prevention, Diagnosis and Therapy. JAMA. 2001; 285 (6): 785-95.
17. Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A., Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res. 2004; 19 (6): 1006-12.
18. Lang TF, LeBlanc AD, Evans HJ, Lu Y., Adaptation of the proximal femur to skeletal reloading after long-duration spaceflight. J Bone Miner Res. 2006; 21 (8): 1224-30.
19. Riggs BL, Melton LJ 3rd, Robb RA, Camp JJ, Atkinson EJ, Peterson JM, Rouleau PA, McCollough CH, Bouxsein ML, Khosla S., Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res. 2004; 19 (12): 1945-54.
20. Sukumar D, Ambia-Sobhan A, Zurfluh R, Schlussel Y, Stahl TJ, Gordon CL, Shapses SA., Areal and volumetric bone mineral density and geometry at two levels of protein intake during caloric restriction: a randomized, controlled trial. J Bone Miner Res. 2011; 26 (6): 1339-48.
21. Carpenter RD, LeBlanc AD, Evans H, Sibonga JD, Lang TF., Long-term changes in the density and structure of the human hip and spine after long-duration spaceflight. Acta Astronautica. 2010; 67: 71-81.
22. Keyak JH, Koyama AK, LeBlanc A, Lu Y, Lang TF., Reduction in proximal femoral strength due to long-duration spaceflight. Bone. 2009; 44 (3): 449-53.
23. Smith SM, Wastney ME, O'Brien KO, Morukov BV, Larina LM, Abrams SE, Davis-Street JE, Oganov V, Shackelford LC., Bone markers, calcium metabolism, and calcium kinetics during extended-duration space flight on the Mir space station. J Bone Miner Res. 2005; 20 (2): 208-18.
24. Melton LJ 3rd, Riggs BL, Keaveny TM, Achenbach SJ, Hoffmann PF, Camp JJ, Rouleau PA, Bouxsein ML, Amin S, Atkinson EJ, Robb RA, Khosla S., Structural determinants of vertebral fracture risk. J Bone Miner Res. 2007; 22 (12): 1885-92.
25. Black DM, Bouxsein ML, Marshall LM, Cummings SR, Lang TF, Cauley JA, Ensrud KE, Nielson CM, Orwoll ES., Osteoporotic Fractures in Men (Mr. OS) Research Group. Proximal femoral structure and the prediction of hip fracture in men: a large prospective study using QCT. J Bone Miner Res. 2008; 23 (8): 1326-33.
26. Vico L, Collet P, Guignandon A, Lafage-Proust MH, Thomas T, Rehailia M, Alexandre C., Effects of long-term microgravity exposure on cancellous and cortical weight-bearing bones of cosmonauts. Lancet. 2000; 355: 1607-11.
27. Vico L, Chappard D, Alexandre C, Palle S, Minaire P, Riffat G, Morukov B, Rakhmanov S., Effects of a 120 day period of bed-rest on bone mass and bone cell activities in man: attempts at countermeasure. Bone Miner. 1987; 2 (5): 383-94.
28. Thomsen JS, Morukov BV, Vico L, Alexandre C, Saparin PI, Gowin W., Cancellous bone structure of iliac crest biopsies following 370 days of head-down bed rest. Aviat Space Environ Med. 2005; 76 (10): 915-22.
29. Zerwekh JE, Ruml LA, Gottschalk F, Pak CY., The effects of twelve weeks of bed rest on bone histology, biochemical markers of bone turnover, and calcium homeostasis in eleven normal subjects. J Bone Miner Res. 1998; 13 (10): 1594-601.
30. Van der Linden JC, Homminga J, Verhaar J, Weinans H., Mechanical consequences of bone loss in cancellous bone. J Bone Miner Res. 2001; 16 (3): 457-65.
31. Kleerekoper M, Villanueva AR, Stanciu J, Rao DS, Parfitt AM., The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures. Calcif Tissue Int. 1985; 37: 594-7.
32. Riggs BL, Melton LJ 3rd, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S., Population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res. 2008; 23 (2): 205-14.
33. Keyak JH, Sigurdsson S, Karlsdottir G, Oskarsdottir D, Sigmarsdottir A, Zhao S, Kornak J, Harris TB, Sigurdsson G, Jonsson BY, Siggeirsdottir K, Eiriksdottir G, Gudnason V, Lang TR., Male-female differences in prediction of hip fracture during finite element analysis. Bone. 2011; 48 (6): 1239-45.
34. Orwoll ES, Marshall LM, Nielson CM, Cummings SR, Lapidus J, Cauley JA, Ensrud K, Lane N, Hoffmann PR, Kopperdahl DL, Keaveny TM., Osteoporotic Fractures in Med Study Group. Finite element analysis of the proximal femur and hip fracture risk in older men. J Bone Miner Res. 2009; 24 (3): 475-83.
35. Keaveny TM, Kopperdahl DL, Melton LJ 3rd, Hoffmann PF, Amin S, Riggs BL, Khosla S., Age-dependence of femoral strength in white women and men. J Bone Miner Res. 2010; 25 (5): 994-1001.
36. Keyak JH, Kaneko TS, Tehranzadeh J, Skinner HB., Predicting proximal femoral strength using structural engineering models. Clin Orthop Relat Res. 2005; 437: 219-28.
37. Nelson ES, Lewandowski B, Licata A, Myers JG., Development and validation of a predictive bone fracture risk model for astronauts. Ann Biomed Eng. 2009; 37 (11): 2337-59.
38. Leblanc A, Matsumoto T, Jones J, Shapiro J, Lang T, Shackelford L, Smith SM, Evans H, Spector E, Ploutz-Snyder R, Sibonga J, Keyak J, Nakamura T, Kohri K, Ohshima H., Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight. Osteoporos Int. Epub. 2013 Jan 19. DOI: 10.1007/s00198-012-2243-z
39. Parfitt AM., Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med. 1987; 82 (1B): 68-72.