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. 2021 Feb 17;56(4):196–203. doi: 10.1136/bjsports-2020-103602

Table 2.

Biochemical markers of bone turnover and bone metabolism before, during and after spaceflight

Pre-flight FD15 FD30 FD60 FD120 FD180 R+0
n† 17 14 13 14 13 15 17
Bone resorption
CTx (μg/d) 1513 (1068, 1935) 2845 (2047, 4126)** 3009 (2587, 3427)** 3669 (3083, 4708)** 3231 (2609, 4065)** 2768 (2335, 4108)** 2834 (2108, 3909)**
CTx (μg/mmol Cr) 91 (63, 135) 139 (123, 178)** 165 (131, 225)** 191 (161, 226)** 186 (137, 217)** 163 (120, 244)** 145 (112, 207)**
NTx (nmol/d) 390 (323, 439) 606 (461, 954)** 589 (488, 702)** 713 (531, 874)** 600 (449, 905)** 619 (479, 782)** 651 (519, 740)**
NTx (nmol/mmol Cr) 23 (20, 28) 33 (22, 44)** 32 (24, 40)** 34 (28, 53)** 31 (28, 41)** 34 (27, 48)** 38 (29, 45)**
Bone formation
BSAP (U/L) 21.2 (18, 22.5) 20.9 (19.2, 21.9) 19.8 (18.1, 22.8) 23.7 (20.5, 26.3) 25.2 (22.6, 27.2)** 26.9 (22.4, 31.2)** 27 (23.6, 32.5)**
OC (ng/mL) 20.9 (18.3, 23.6) 20.3 (17.9, 26.4) 22.6 (18.2, 27.2) 24.6 (22.6, 28.9) ** 29.9 (28.1, 36.1)** 32.1 (29.4, 39.8)** 26.6 (19.2, 28.7)**
P1NP (μg/L) 48.8 (42.3, 57.1) 46.3 (35.4, 58.4) 51.2 (48.9, 58.8) 75.1 (68.8, 82.1) ** 99.5 (77.4, 109.8)** 94.4 (74.8, 112.6)** 83.0 (72.0, 100.5)**
Osteocyte activity
Sclerostin (pmol/L) 26.2 (21.3, 31.3) 31.0 (25.9, 35.6) 29.7 (26.3, 36.9)** 30.4 (25.7, 37.1)* 31.5 (24.3, 35.1) 26.9 (22.6, 33.5) 28.7 (21.1, 31.9)
Regulators of bone metabolism
Urinary calcium (mmol/d) 4.86 (4.20, 6.14) 7.43 (5.20, 9.10)** 5.63 (4.51, 6.50)* 6.77 (6.08, 8.00)** 6.64 (4.40, 7.39) 5.06 (3.32, 6.21) 6.56 (5.15, 7.73)
Serum calcium (mmol/L) 2.30 (2.28, 2.35) 2.38 (2.35, 2.45) 2.40 (2.37, 2.42) 2.35 (2.32, 2.40) 2.35 (2.31, 2.41) 2.35 (2.30, 2.45) 2.27 (2.25, 2.40)
PTH (pg/mL) 25.2 (22.1, 31.5) 22.6 (18.0, 27.7) 27.8 (21.3, 30.0) 25.1 (17.0, 32.0) 25.5 (19.0, 32.7) 28.5 (22.0, 36.0) 28.8 (25.5, 35.3)
1,25(OH)2D (pmol/L) 145 (128, 187) 118 (102, 167) 116 (96, 132)* 133 (102, 160) 130 (101, 162) 137 (121, 171) 185 (169, 232)*
25OHD (nmol/L) 86 (76, 96) 82 (65, 86) 77 (72, 87) 81 (72, 86) 79 (74, 85) 80 (67, 84) 77 (74, 81)
Phosphorus (mg/dL) 3.8 (3.4, 4.0) 4.0 (3.9, 4.1) 4.3 (4.0, 4.7)* 4.0 (3.7, 4.3) 4.5 (3.8, 5.1)** 4.2 (3.8, 4.6)* 3.5 (3.2, 3.8)
OPG (pmol/L) 4.7 (3.7, 5.2) 4.5 (4.0, 4.9) 4.5 (4.1, 5.3) 4.7 (4.1, 5.2) 4.8 (4.4, 5.1) 4.5 (4.1, 5.3) 4.7 (4.1, 5.6)
RANKL (pmol/L) 217 (124, 312) 198 (110, 304) 222 (167, 318) 171 (134, 273) 183 (123, 296) 207 (144, 317) 140 (114, 287)
RANKL/OPG 46 (31, 68) 47 (29, 63) 45 (37, 71) 40 (30, 57) 37 (29, 60) 48 (28, 81) 29 (20, 67)
Chemistry
24 hours urine volume (mL) 1741 (1475, 2062) 1408 (1020, 1845) 1302 (1156, 1775) 1472 (1221, 2241) 1291 (1130, 1922) 1358 (1123, 2025) 1921 (1602, 2549)
Urinary creatinine (mmol/d) 17 (16, 18) 20 (18, 21) 20 (18, 23) 20 (18, 21) 19 (16, 21) 20 (17, 24) 18 (17, 19)
Serum creatinine (mg/dL) 1.00 (0.90, 1.00) 1.00 (0.90, 1.03) 1.00 (0.90, 1.10) 0.97 (0.87, 1.00) 0.99 (0.90, 1.10) 1.00 (0.88, 1.10) 0.90 (0.78, 0.90)**

Data are median (IQR).

*p<0.05; **p<0.01 compared with pre-flight (mean of L-180 and L-45) based on linear mixed effects model with small sample adjustment and Bonferroni correction. OC, 25OHD, RANKL and RANKL/OPG were log-transformed for analysis.

†Maximum sample size for data collection period. Three participants did not have CTx analysed at any timepoint.

BSAP, bone-specific alkaline phosphatase; CTx, type I collagen C-terminal cross-linked telopeptide; NTx, type I collagen N-terminal cross-linked telopeptide; OC, osteocalcin; 25OHD, 25-hydroxyvitamin D; 1,25(OH)2D, 1,25 di-hydroxyvitamin D; OPG, osteoprotegerin; P1NP, procollagen type 1 amino-terminal propeptide; PTH, intact parathyroid hormone.