Effect of potassium citrate on bone density, microarchitecture, and fracture risk in healthy older adults without osteoporosis: a randomized controlled trial.
J Clin Endocrinol Metab
; 98(1): 207-17, 2013 Jan.
Article
em En
| MEDLINE
| ID: mdl-23162100
ABSTRACT
CONTEXT The acid load imposed by a modern diet may play an important role in the pathophysiology of osteoporosis. OBJECTIVE:
Our objective was to evaluate the skeletal efficacy and safety and the effect on fracture prediction of K-citrate to neutralize diet-induced acid loads. DESIGN ANDSETTING:
We conducted a randomized, double-blind, placebo-controlled trial at a teaching hospital.SUBJECTS:
Subjects included 201 elderly (>65 yr old) healthy men and women (t-score of -0.6 at lumbar spine). INTERVENTION Intervention was 60 mEq of K-citrate daily or placebo by mouth. All subjects received calcium and vitamin D. OUTCOMEMEASURES:
The primary outcome was change in areal bone mineral density (aBMD) at the lumbar spine by dual-energy x-ray absorptiometry after 24 months. Secondary endpoints included changes in volumetric density and microarchitectural parameters by high-resolution peripheral quantitative computed tomography in both radii and both tibiae and fracture risk assessment by FRAX (Switzerland).RESULTS:
K-citrate increased aBMD at lumbar spine from baseline by 1.7 ± 1.5% [95% confidence interval (CI) = 1.0-2.3, P < 0.001] net of placebo after 24 months. High-resolution peripheral quantitative computed tomography-measured trabecular densities increased at nondominant tibia (1.3 ± 1.3%, CI = 0.7-1.9, P < 0.001) and nondominant radius (2.0 ± 2.0%, CI = 1.4-2.7, P < 0.001). At nondominant radius, trabecular bone volume/tissue volume increased by 0.9 ± 0.8%, (CI = 0.1-1.7), trabecular thickness by 1.5 ± 1.6% (CI = 0.7-2.3), and trabecular number by 1.9 ± 1.8% (CI = 0.7-3.1, for all, P < 0.05). K-citrate diminished fracture prediction score by FRAX significantly in both sexes.CONCLUSIONS:
Among a group of healthy elderly persons without osteoporosis, treatment with K-citrate for 24 months resulted in a significant increase in aBMD and volumetric BMD at several sites tested, while also improving bone microarchitecture. Based on the effect on fracture prediction, an effect on future fractures by K-citrate is possible.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osso e Ossos
/
Densidade Óssea
/
Saúde
/
Citrato de Potássio
/
Fraturas Ósseas
Tipo de estudo:
Clinical_trials
/
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2013
Tipo de documento:
Article