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Association between changes in serum bone metabolism markers and bone microarchitecture changes during basic combat

Jennifer C Coulombe1, Brittany N Bozzini2, Katelyn I Guerriere2

  • 1U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA; Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.

Bone
|August 25, 2024
PubMed
Summary
This summary is machine-generated.

Basic Combat Training (BCT) increases bone formation marker PINP, particularly in the first four weeks. Higher PINP levels correlate with improved tibial bone mineral density and structure in soldiers undergoing BCT.

Keywords:
Bone turnoverCTXHR-pQCTMicroarchitecturePINPSoldiers

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Bone Biology

Background:

  • U.S. Army Basic Combat Training (BCT) enhances tibial bone mineral density (BMD) and structure in most soldiers.
  • Few studies have explored the association between serum bone biomarkers and skeletal changes during BCT.

Purpose of the Study:

  • To characterize changes in serum bone biomarkers during BCT.
  • To investigate the relationship between these biomarker changes and alterations in tibial BMD and bone structure.

Main Methods:

  • A prospective observational study of 235 U.S. Army trainees over ten weeks of BCT.
  • Weekly blood samples were collected to measure Procollagen type 1 N-terminal propeptide (PINP) and C-terminal telopeptide of type 1 collagen (CTX) every two weeks.
  • Tibial BMD, structure, and microarchitecture were assessed using dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography at baseline and post-BCT.

Main Results:

  • In female trainees, PINP significantly increased during and post-BCT, peaking at week four (45.4%).
  • Male trainees also showed increased PINP at weeks two and four (21.9% and 35.9%, respectively), with decreased CTX observed at multiple time points.
  • The change in PINP from baseline to week four positively correlated with improvements in tibial BMD, bone structure, and microarchitecture post-BCT.

Conclusions:

  • The bone formation marker PINP significantly increases during U.S. Army BCT, with the most substantial rise occurring in the initial four weeks.
  • Elevated PINP levels during BCT are associated with enhanced tibial bone mineral density and structural improvements.
  • Changes in the bone resorption marker CTX were not significantly correlated with skeletal improvements in this cohort.