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Nutrients. 2018 Sep 12;10(9). pii: E1293. doi: 10.3390/nu10091293.

Potassium Citrate Supplementation Decreases the Biochemical Markers of Bone Loss in a Group of Osteopenic Women: The Results of a Randomized, Double-Blind, Placebo-Controlled Pilot Study.

Author information

1
Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy. donatella.granchi@ior.it.
2
Villalba Hospital, GVM Care and Research, Via di Roncrio, 25, 40136 Bologna, Italy. renata.caudarella@alice.it.
3
Osteoporosis and Metabolic Bone Disease Unit, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy. claudio.ripamonti@ior.it.
4
Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy. paolo.spinnato@ior.it.
5
Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1, 40136 Bologna, Italy. alberto.bazzocchi@ior.it.
6
Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy. annamaria.massa88@gmail.com.
7
Laboratory for Orthopedic Pathophysiology and Regenerative Medicine, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy. nicola.baldini@ior.it.
8
Department of Biomedical and Neuromotor Sciences, Via Pupilli 1, University of Bologna, 40136 Bologna, Italy. nicola.baldini@ior.it.

Abstract

The relationship involving acid-base imbalance, mineral metabolism and bone health status has previously been reported but the efficacy of the alkalizing supplementation in targeting acid overload and preventing bone loss has not yet been fully elucidated. In this randomized, double-blind, placebo-controlled study, the hypothesis that potassium citrate (K citrate) modifies bone turnover in women with postmenopausal osteopenia was tested. Three hundred and ten women were screened; 40 women met the inclusion criteria and were randomly assigned to the treatment or the placebo group. They were treated with K citrate (30 mEq day-1) or a placebo in addition to calcium carbonate (500 mg day-1) and vitamin D (400 IU day-1). At baseline and time points of 3 and 6 months, serum indicators of renal function, electrolytes, calciotropic hormones, serum bone turnover markers (BTMs), tartrate-resistant acid phosphatase 5b (TRACP5b), carboxy-terminal telopeptide of type I collagen (CTX), bone alkaline phosphatase (BAP), procollagen type 1 N terminal propeptide (PINP)), and urine pH, electrolytes, and citrate were measured. The follow-up was completed by 17/20 patients in the "K citrate" group and 18/20 patients in the "placebo" group. At baseline, 90% of the patients exhibited low potassium excretion in 24 h urine samples, and 85% of cases had at least one urine parameter associated with low-grade acidosis (low pH, low citrate excretion). After treatment, CTX and BAP decreased significantly in both groups, but subjects with evidence of low-grade acidosis gained significant benefits from the treatment compared to the placebo. In patients with low 24h-citrate excretion at baseline, a 30% mean decrease in BAP and CTX was observed at 6 months. A significant reduction was also evident when low citrate (BAP: -25%; CTX: -35%) and a low pH (BAP: -25%; CTX: -30%) were found in fasting-morning urine. In conclusion, our results suggested that K citrate supplementation improved the beneficial effects of calcium and vitamin D in osteopenic women with a documented potassium and citrate deficit, and a metabolic profile consistent with low-grade acidosis.

KEYWORDS:

acid-base; bone remodeling; bone turnover markers; osteopenia; potassium citrate; urolithiasis

PMID:
30213095
PMCID:
PMC6164684
DOI:
10.3390/nu10091293
[Indexed for MEDLINE]
Free PMC Article

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