Characteristics of bone metabolism disorders in military personnel in the Arctic regions: prospective study

Abstract

OBJECTIVE. To study characteristics of bone metabolism disorders in military personnel in the Arctic regions.
 MATERIALS AND METHODS. The survey was conducted and medical documentation of 189 male soldiers aged 23–42 (average age - 29,6±5,6) was studied. Depending on the duty station all the surveyed were divided into two groups: I – 107 soldiers, performing military service in the Arctic regions with at least 2 years of experience, II – 82 soldiers from the Western Military Region. Complaints, anamnesis data, objective status (including anthropometry) and medical documentation were assessed and studied in the surveyed military personnel. For estimating bone-mineral density, the method of calcaneus ultrasonography, using «GE Healthcare Achilles» densitometer was applied. The content of total calcium, inorganic phosphorus as well as the concentration of bone resorption markers – СТХ and NTX in the blood serum were used as analyzed laboratory rate of bone metabolism.
 RESULTS. The study showed that almost half of the military personnel in the Arctic regions (48,6%) had the rate of bone-mineral density below the average value for healthy men of the same age group. It was noted that prevalence of osteopenia in the Arctic is significantly higher compared to military personnel from temperate regions. When studying bone resorption markers, it was noted that the group of Arctic military personnel experienced statistically significant increase in NTX, characterizing the rate of degradation in the newly formed bone as well as the tendency towards increase in CTX, reflecting the rate of degradation relative to the old bone.
 DISCUSSION. The main link in the pathogenesis of low bone-mineral density in military personnel in the unfavorable Arctic environment is D3 vitamin metabolism disorder by lowering its formation in the skin and also it limited intake with food. High prevalence of disorder in bone-mineral density among Arctic military personnel might indicate the need for a more rigorous selection process in the Arctic regions with a mandatory in-depth survey of the bone metabolism system (determination of total calcium content, inorganic phosphorus, D3 vitamin) as well as performing according to osteodensitometry. It is advisable to conduct an annual survey of the Arctic military personnel at the duty station, involving a visiting military-medical commission with a therapist or rheumatologist as its member.