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Sleep restriction with circadian disruption negatively alter bone turnover markers in women.

Swanson CM; Shea SA; Kohrt WM; Wright KP Jr.; Cain SW; Munch M; Vujovic N; Czeisler CA; Orwoll ES; Buxton OM

J Clin Endocrinol Metab 2020 Jul; 105(7):2456-2463

https://doi.org/10.1210/clinem/dgaa232

20061633

Purpose: The purpose of this work is to determine whether an uncoupling of bone turnover markers (BTMs) occurs in women exposed to the combination of sleep restriction with circadian disruption (SRCD), as previously reported in men. Methods: Four bone biomarkers (N-terminal propeptide of type I procollagen [P1NP] and osteocalcin = bone formation; C-telopeptide [CTX] = bone resorption; sclerostin = bone formation inhibitor) were measured in bihourly samples over 24 hours at baseline and after approximately 3 weeks of sleep restriction (approx. 5.6 hours of sleep/24 hours) with concurrent circadian disruption (SRCD, recurring 28-hour "day" in dim light). Maximum likelihood estimation in a repeated-measures model was used to assess the effects of SRCD and age on bone biomarkers. Results: Five women were young (22 +/- 2.8 years) and four were older (58 +/- 1.8 years). Baseline bone biomarker levels did not differ by age (all P >/= .07). Bone formation markers were lower after SRCD (estimate +/- SEE, delta P1NP = -9.5 +/- 2.8 ug/L, P = .01; delta osteocalcin = -2.3 +/- 0.9 ng/mL, P = .04). The P1NP decline was greater in young women (delta P1NP = -12.9 +/- 3.7 ug/L, P = .01). After SRCD, CTX was significantly higher in young women (0.182 +/- 0.069 ng/mL, P = .04) but did not change in older women. Conclusions: These pilot data are similar to previous findings in men and suggest that SRCD negatively altered bone metabolism in women by decreasing markers of bone formation and, in young women, increasing a marker of bone resorption. If sustained, this pattern of BTM uncoupling may lead to bone loss and lower bone mineral density.

Sleep; Sleep deprivation; Circadian rhythms; Biomarkers; Total Worker Health; TWH; Bone disorders; Age factors; Women; Author Keywords: sleep; bone turnover markers; P1NP; CTX; circadian disruption; shift work

Christine M. Swanson, MD, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave., Mail Stop 8106, Aurora, CO 80045

JCEMAZ

20200701

Journal Article

Christine.Swanson@CUAnschutz.edu

Cooperative Agreement

2020

Cooperative-Agreement-Number-U19-OH-010154

7

0021-972X

Services; Transportation, Warehousing and Utilities

Journal of Clinical Endocrinology and Metabolism

OR; CO; MA; PA

Oregon Health & Science University, Portland, Oregon