Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women (original) (raw)
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School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Department of Nutrition Science (NUTR), Purdue University, West Lafayette, IN, USA
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Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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Department of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, CA, USA
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School of Medicine, Johns Hopkins University, Baltimore, MD, USA
The Johns Hopkins Bayview Medical Center, 5200 Eastern Ave, Mason F Lord Center Tower, Suite 4300, Baltimore, MD 21224, USA.
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Revision received:
22 August 2012
Accepted:
04 September 2012
Published:
18 September 2012
Cite
Kendall F Moseley, Connie M Weaver, Lawrence Appel, Anthony Sebastian, Deborah E Sellmeyer, Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women, Journal of Bone and Mineral Research, Volume 28, Issue 3, 1 March 2013, Pages 497–504, https://doi.org/10.1002/jbmr.1764
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Abstract
The dietary acid load created by the typical Western diet may adversely impact the skeleton by disrupting calcium metabolism. Whether neutralizing dietary acid with alkaline potassium salts results in sustained improvements in calcium balance remains controversial. In this randomized, double‐blind, placebo‐controlled study, 52 men and women (mean age 65.2 ± 6.2 years) were randomly assigned to potassium citrate 60 mmol/d, 90 mmol/d, or placebo daily with measurements of bone turnover markers, net acid excretion, and calcium metabolism, including intestinal fractional calcium absorption and calcium balance, obtained at baseline and at 6 months. At 6 months, net acid excretion was significantly lower in both treatment groups compared to placebo and it was negative, meaning subjects' dietary acid was completely neutralized (−11.3 mmol/d on 60 mmol/d; −29.5 mmol/d on 90 mmol/d, p < 0.001 compared to placebo). At 6 months, 24‐hour urine calcium was significantly reduced in persons taking potassium citrate 60 mmol/d (−46 ± 15.9 mg/d) and 90 mmol/d (−59 ± 31.6 mg/d) compared with placebo (p < 0.01). Fractional calcium absorption was not changed by potassium citrate supplementation. Net calcium balance was significantly improved in participants taking potassium citrate 90 mmol/d compared to placebo (142 ± 80 mg/d on 90 mmol/d versus −80 ± 54 mg/d on placebo; p = 0.02). Calcium balance was also improved on potassium citrate 60 mmol/d, but this did not reach statistical significance (p = 0.18). Serum C‐telopeptide decreased significantly in both potassium citrate groups compared to placebo (−34.6 ± 39.1 ng/L on 90 mmol/d, p = 0.05; −71.6 ± 40.7 ng/L on 60 mmol/d, p = 0.02) whereas bone‐specific alkaline phosphatase did not change. Intact parathyroid hormone was significantly decreased in the 90 mmol/d group (p = 0.01). Readily available, safe, and easily administered in an oral form, potassium citrate has the potential to improve skeletal health. Longer‐term trials with definitive outcomes such as bone density and fracture are needed. © 2013 American Society for Bone and Mineral Research.
Copyright © 2013 American Society for Bone and Mineral Research
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