On the combined effects of normobaric hypoxia and bed rest upon bone and mineral metabolism: Results from the PlanHab study
Open accessAbstract
Bone losses are common as a consequence of unloading and also in patients with chronic obstructive pulmonary disease (COPD). Although hypoxia has been implicated as an important factor to drive bone loss, its interaction with unloading remains unresolved. The objective therefore was to assess whether human bone loss caused by unloading could be aggravated by chronic hypoxia. In a cross-over designed study, 14 healthy young men underwent 21-day interventions of bed rest in normoxia (NBR), bed rest in hypoxia (HBR), and hypoxic ambulatory confinement (HAmb). Hypoxic conditions were equivalent to 4000m altitude. Bone metabolism (NTX, P1NP, sclerostin, DKK1) and phospho-calcic homeostasis (calcium and phosphate serum levels and urinary excretion, PTH) were assessed from regular blood samples and 24-hour urine collections, and tibia and femur bone mineral content was assessed by peripheral quantitative computed tomography (pQCT). Urinary NTX excretion increased (P<0.001) to a similar extent in NBR and HBR (P=0.69) and P1NP serum levels decreased (P=0.0035) with likewise no difference between NBR and HBR (P=0.88). Serum total calcium was increased during bed rest by 0.059 (day D05, SE 0.05mM) to 0.091mM (day D21, P<0.001), with no additional effect by hypoxia during bed rest (P=0.199). HAmb led, at least temporally, to increased total serum calcium, to reduced serum phosphate, and to reduced phosphate and calcium excretion. In conclusion, hypoxia did not aggravate bed rest-induced bone resorption, but led to changes in phospho-calcic homeostasis likely caused by hyperventilation. Whether hyperventilation could have mitigated the effects of hypoxia in this study remains to be established.
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- Authors
- Rittweger, J., Debevec, T., Frings-Meuthen, P., Lau, P., Mittag, U., Ganse, B., Ferstl, P. G., Simpson, E. J., Macdonald, I. A., Eiken, O., & Mekjavic, I. B.
- Affiliations
- University of Cologne (DE)
- Jožef Stefan Institute (SI)
- Deutsches Zentrum für Luft- und Raumfahrt e. V. (DLR) (DE)
- Goethe University Frankfurt (DE)
- University of Nottingham (GB)
- KTH Royal Institute of Technology (SE)
- Corresponding author
- Rittweger, Jörn
- ORCID
- Venue
- Bone
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 91
- Pages
- 130-138
- ISSN
- 1873-2763 (ISSN-L)
- 8756-3282
- OpenAlex
- W2478348291
- Cited by
- 35
- References
- 54
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 8 · 2018: 2 · 2017: 6 · 2016: 1
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Bone (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by)
- elib (German Aerospace Center) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Publication Server of Goethe University Frankfurt am Main (Goethe University Frankfurt) (submittedVersion, cc-by)
- Funders
- European Union Seventh Framework Programme (284438)
- European Space Agency (40001043721/11/NL/KML)
- Slovene Research Agency (L3-3654)
- DLR (2475 101)
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Keywords
- normobaric hypoxia, bed rest, bone loss, bone mineral metabolism, mineral metabolism, bone resorption, hyperventilation, sclerostin, DKK1, P1NP, urinary NTX, serum calcium, serum phosphorus, parathyroid hormone, chronic obstructive pulmonary disease
- MeSH terms
- Adult, Alkaline Phosphatase, Hypoxia, Bed Rest, Bone and Bones, Calcium, Carbon Dioxide, Genetic Markers, Humans, Male, Minerals, Osteogenesis, Parathyroid Hormone, Partial Pressure, Peptide Fragments, Phosphates, Procollagen, Bone Density, Bone Morphogenetic Proteins, Intercellular Signaling Peptides and Proteins, Adaptor Proteins, Signal Transducing
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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