EFFECT OF POTASSIUM BICARBONATE ON BONE AND MUSCLE

碳酸氢钾对骨骼和肌肉的影响

• 批准号: 7081629
• 负责人: Bess Dawson-Hughes
• 金额: $ 34.76万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7081629
• 关键词: acidity /alkalinity; acidosis; atrophy; bicarbonates; biomarker; blood tests; calcium metabolism; clinical research; combination therapy; diet therapy; dietary potassium; dietary supplements; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; longitudinal human study; muscle function; muscle metabolism; nitrogen metabolism; nutrition of aging; nutrition related tag; parathyroid hormones; pathogenic diet; pathologic bone resorption; sarcopenia; urinalysis

DESCRIPTION (provided by applicant): Metabolic acidosis causes bone loss and muscle wasting. On a daily basis, adults on normal Western diets generate approximately 75-100 meq/d of acid. As individuals age, their renal function and ability to excrete acid decline and they become more acidotic. Alkalinizing the diet with supplemental potassium bicarbonate (KHCO3) reduces urinary calcium excretion, lowers bone turnover rates (biochemical markers of bone resorption) and reduces urinary nitrogen excretion (an indicator of muscle catabolism) acutely in subjects on acidogenic metabolic diets. Currently there is no concensus on the relative contributions of potassium (which may increase renal calcium retention) and bicarbonate (shown to reduce net acid excretion) on decreasing bone turnover. We postulate that HCO3 may also reduce N2 (muscle) wasting in older persons. There is no evidence at this time that KHCO3 or its components will have a sustained impact on bone turnover or nitrogen wasting under field conditions.The proposed study will determine the effect of potassium and bicarbonate, alone and in combination, on serum PTH, biochemical markers of bone turnover, calcium excretion, calcium absorption and urinary nitrogen. 192 men and women will be randomly assigned to treatment with 67.5 mmol of KHC03, KCI, or NaHCOS or with placebo daily for 12 weeks. Subjects will visit the Center at baseline, 3, 7, and 12 weeks for assessment of their diets, pill compliance, and weight. They will have the following measurements on selected study visits: muscle function tests, serum calcium, potassium, parathyroid hormone, and osteocalcin and 24-hr urinary calcium, N-telopeptide, calcium absorption, potassium, sodium, creatinine, titratable acid, renal net acid excretion, and nitrogen. In the analysis, the final value will be the response and the baseline value will be a covariate. If effective in reducing calcium excretion, bone turnover, and/or nitrogen wasting, then treatment with potassium, bicarbonate, or the two combined would warrant further evaluation as a potentially inexpensive and safe means to reduce bone loss and muscle wasting in the elderly.

描述（由申请人提供）：代谢性酸中毒会导致骨质流失和肌肉浪费。每天，正常西方饮食的成年人会产生约75-100 meq/d的酸。随着个体的年龄，其肾功能和排泄酸下降的能力并变得更加酸性。用补充碳酸氢钾（KHCO3）碱化饮食可降低尿钙排泄，降低骨骼的转换率（骨吸收的生化标记），并在酸性代理饮食中明显地降低了泌尿氮的排泄（肌肉分解的指标）。当前，钾（可能增加肾钙保留率）和碳酸氢盐（显示净酸排泄）对降低骨转换的相对贡献尚无共识。我们假设HCO3还可以减少老年人的N2（肌肉）浪费。目前尚无证据表明KHCO3或其成分在现场状况下会持续对骨转换或氮浪费产生持续的影响。拟议的研究将确定钾和碳酸氢盐，单独和碳酸氢盐对血清PTH，血清PTH，骨化，骨骼的生物化学标记，钙量，钙的量，钙化，钙化菌株和钙化菌株的影响。 192名男女将被随机分配给67.5 mmol的KHC03，KCI或Nahcos或每天安慰剂，持续12周。受试者将在基线，第3、7和12周访问中心，以评估饮食，药丸的依从性和体重。他们将对选定的学习访问进行以下测量：肌肉功能测试，血清钙，钾，甲状旁腺激素和骨钙素以及24小时的尿钙，N-甲基肽，钙吸收，钾，钾，钠，肌酐，肌酐，钛酸，肾酸的灭绝和NITROGON和NITROGON。在分析中，最终值将是响应，基线值将是协变量。如果有效减少钙排泄，骨骼更新和/或氮浪费，则用钾，碳酸氢盐或两种合并的处理有效，将有必要进一步评估，作为减少老年人中骨质流失和肌肉的潜在廉价和安全手段。