No abstract

Background Diets rich in animal protein, such as the typical American diet, are thought to create a high acid load. An association between acid load and bone loss has led to the idea that providing positive alkaline salt therapy could have beneficial effects on bone metabolism. Objective To investigate the effects of potassium citrate (K-citrate), 40 mEq daily, over one year on bone resorption and formation. Design A randomized, double-blind, placebo-controlled trial of 83 women with postmenopausal osteopenia. Levels of bone turnover markers, specifically urinary N-telopeptide of collagen type I (u-NTX), amino-terminal propeptide of type I procollagen (P1NP) bone specific alkaline phosphatase (BSAP) and osteocalcin (OC) were compared. Changes in bone mineral density (BMD) were also examined. Results K-Citrate decreased both u-NTX (p=0.005) and serum P1NP (p = <0.001) starting at month 1 and continuing through month 12. No significant change was seen in BSAP or OC. No significant change was seen in lumbar or hip BMD between the two groups. Conclusions In women with postmenopausal osteopenia, treatment with K- citrate for one year resulted in a significant decrease in markers of turnover. The effect on markers of bone formation was not consistent. K-citrate may serve as a potential treatment for bone loss that is well tolerated without any significant known long term consequences.