ECTS2013 Poster Presentations Osteoporosis: pathophysiology and epidemiology (49 abstracts)
Microgravity-induced osteoporosis: a challenge for the future of space programs
Prisco Piscitelli 1, , Alberto Argentiero 1 , Giovanna Chitano 1 , Cosimo Neglia 1 , Emiliano Sordi 1, , Giovanni Iolascon 4 , Alessandro Distante 1 & Maria Luisa Brandi 2
1Euro Mediterranean Scientific Biomedical Institute, Brinsisi, Apulia, Italy; 2University of Florence, Florence, Italy; 3Italian Aeronautics Army, Rome, Italy; 4Second University of Naples, Naples, Italy.
Objective(s): We aimed to determine the impact of microgravity-induced osteoporosis on the future of space programs.
Material and methods: We performed a metanalysis of the available literature, finding out different studies about i) muscle atrophy due to the absence of workload, which can consequently induce bone loss; ii) the effect of long term inactivity on bone mass; iii) the effect of calcium and vitamin D supplementation in women and men in order to prevent bone loss; iv) the effect of bisphosphonates in preventing bone resorption due to long term inactivity (animal models); v) studies concerning osteoporosis carried out during space missions.
Results: Unloading of weight bearing bones as induced by microgravity or immobilization has significant impacts on the calcium and bone metabolism and is the most likely cause for space osteoporosis. During a 4.5–6 month stay in space most of the astronauts develop a reduction in bone mineral density in spine, femoral neck, trochanter, and pelvis of 1–1.6% measured by dual energy X-ray absorption (DEXA). Dependent on the mission length and the individual turnover rates of the astronauts it can even reach individual losses of up to 14% in the femoral neck. Calcaneal mineral density is lost at a 5% rate of its mass each month. Attempts to prevent disuse osteoporosis with both mechanical and biochemical means, including exercise, skeletal compression, increased hydrostatic pressure to the lower body, supplemental calcium and/or phosphorus, calcitonin, or etidronate were not successful. In Gemini, Apollo, and Skylab astronauts it was shown a negative calcium balance due primarily to hypercalciuria. Altered bone cell activity would probably result in irreversible bone loss with the premature development of senile osteoporosis many years after space flight.
Conclusion(s): Microgravity-induced osteoporosis represents a challenge for the future of space programs and therefore needs to be furhter investigated.
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