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Potassium Bicarbonate Supplementation Lowers Bone Turnover and Calcium Excretion in Older Men and Women: A Randomized Dose‐Finding Trial
Author(s) -
DawsonHughes Bess,
Harris Susan S,
Palermo Nancy J,
Gilhooly Cheryl H,
Shea M Kyla,
Fielding Roger A,
Ceglia Lisa
Publication year - 2015
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2554
Subject(s) - creatinine , medicine , placebo , endocrinology , bone remodeling , urinary calcium , urine , n terminal telopeptide , excretion , calcium , urinary system , alkaline phosphatase , chemistry , biochemistry , osteocalcin , alternative medicine , pathology , enzyme
The acid load accompanying modern diets may have adverse effects on bone and muscle metabolism. Treatment with alkaline salts of potassium can neutralize the acid load, but the optimal amount of alkali is not established. Our objective was to determine the effectiveness of two doses of potassium bicarbonate (KHCO 3 ) compared with placebo on biochemical markers of bone turnover, and calcium and nitrogen (N) excretion. In this double‐blind, randomized, placebo‐controlled study, 244 men and women age 50 years and older were randomized to placebo or 1 mmol/kg or 1.5 mmol/kg of KHCO 3 daily for 3 months; 233 completed the study. The primary outcomes were changes in 24‐hour urinary N‐telopeptide (NTX) and N; changes in these measures were compared across the treatment groups. Exploratory outcomes included 24‐hour urinary calcium excretion, serum amino‐terminal propeptide of type I procollagen (P1NP), and muscle strength and function assessments. The median administered doses in the low‐dose and high‐dose groups were 81 mmol/day and 122 mmol/day, respectively. When compared with placebo, urinary NTX declined significantly in the low‐dose group ( p = 0.012, after adjustment for baseline NTX, gender, and change in urine creatinine) and serum P1NP declined significantly in the low‐dose group ( p = 0.004, adjusted for baseline P1NP and gender). Urinary calcium declined significantly in both KHCO 3 groups versus placebo ( p < 0.001, adjusted for baseline urinary calcium, gender, and changes in urine creatinine and calcium intake). There was no significant effect of either dose of KHCO 3 on urinary N excretion or on the physical strength and function measures. KHCO 3 has favorable effects on bone turnover and calcium excretion and the lower dose appears to be the more effective dose. Long‐term trials to assess the effect of alkali on bone mass and fracture risk are needed. © 2015 American Society for Bone and Mineral Research.