The Role of Bone in the Regulation of Systemic Acid-Base Balance

Green, Jacob

doi:10.1159/000420160

Cited by 30 publications

(37 citation statements)

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“…This finding was confirmed in a subsequent case–control study, demonstrating a normal renal acidification in all 20 control subjects and an impaired renal distal acidification in 10 of 46 (22%) patients with osteopenia or osteoporosis [31]. Defective renal acidification may lead to bone loss through direct physico‐chemical effects of even mild acidosis on bone [32]. Furthermore, even incomplete RTA I leads to an osteoblast‐mediated activation of osteoclasts [32].…”

Section: Discussionmentioning

confidence: 74%

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density

Deutschmann

Weger

et al. 2002

Journal of Internal Medicine

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Abstract. Deutschmann HA, Weger M, Weger W, Kotanko P, Deutschmann MJ, Skrabal F (Krankenhaus der Barmherzigen Brü der, Marschallgasse, Teaching Hospital of the Karl-Franzens University Graz, Austria). Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density. J Intern Med 2002; 252: 389-397.Objectives. To determine whether the use of more elaborate diagnostic tests can identify possible risk factors for secondary osteoporosis and to evaluate the impact of these possible risk factors on the severity of bone disease in the study population. Design. Cross-sectional study. Setting and participants. We have investigated 377 subjects (285 females, 92 males) with osteoporosis (T-score less than )2.5 in dual energy X-ray absorption) or nontraumatic lumbar vertebral fractures; these patients were referred to our hospital, a secondary care centre, for evaluation and treatment of osteoporosis. Results. Osteoporosis without attributable risk factor was diagnosed in 106 women (37%) and 30 men (33%). In 241 patients (179 women, 62 men) one or more possible risk factors for osteoporosis (in this paper also called subclinical disease) were revealed.The most common were lactose malabsorption, disturbed exocrine pancreatic function and renal tubular disturbances, including renal hypercalciuria, incomplete renal tubular acidosis and mild phosphate diabetes. The number of possible risk factors in the individual patient was significantly related to the severity of osteoporosis as assessed by Z-scores (Spearman correlation r ¼ )0.43, P < 0.001, n ¼ 172 for females; r ¼ )0.28, P < 0.05, n ¼ 65 for males). Conclusions. All the identified subclinical diseases would have remained undetected if the currently accepted guidelines for the investigation of patients with osteoporosis were applied. The statistically significant correlation between the number of identified possible risk factors and the severity of bone disease in the individual patient strongly suggests the pathogenetic significance of the identified subclinical diseases. It is yet to be shown, whether specific treatment of these subclinical diseases yields additional improvement of bone mass as compared with standard treatment of osteoporosis.

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Section: Discussionmentioning

confidence: 74%

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density

Deutschmann

Weger

et al. 2002

Journal of Internal Medicine

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“…The role of bone in acid–base balance is indeed complex and the area has been well reviewed by Green & Kleeman (1991) and more recently by Barzel (1995). In these reviews, the skeleton itself has been referred to as ‘a giant ion‐exchange column loaded with an alkali buffer’, because 80% of body carbonate, 80% of body citrate and 35% of body sodium are contained in solution within the hydration shell of bone and are released in response to metabolic acid.…”

Section: Acid–base Status and The Skeletonmentioning

confidence: 99%

Fruit and vegetable consumption and skeletal health: is there a positive link?

New

2001

Nutrition Bulletin

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Summary The health‐related benefits of a high consumption of ‘fruit and vegetables’ and the influence of this food group on a variety of diseases has been gaining increasing prominence in the literature over a number of years. Of considerable interest to the osteoporosis field is the role that bone plays in acid–base balance. Surprisingly, consideration of the skeleton as a source of ‘buffer’, contributing to both the preservation of the body's pH and the defence of the system against acid–base disorders has been in existence for many years, yet it is only more recently that the possibility of a positive link between a high consumption of fruit and vegetables and indices of bone health has been more fully discussed. The following review reports on a plenary paper presented at the Fourth International Symposium on Nutritional Aspects of Osteoporosis (May 2000, Switzerland), which looks specifically at the importance of these alkaline‐forming foods on skeletal health.

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“…However, the consequence of using alkali in the bones as a buffer is increased calcium excretion and decreased bone mass (1). What role subtle, chronic acid retention plays in causing osteoporosis is an important but only partially answered question.…”

Section: Introductionmentioning

confidence: 99%

Potassium Citrate Decreases Bone Resorption in Postmenopausal Women with Osteopenia: A Randomized, Double-Blind Clinical Trial

et al. 2015

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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.

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The Role of Bone in the Regulation of Systemic Acid-Base Balance

Cited by 30 publications

References 0 publications

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density

Fruit and vegetable consumption and skeletal health: is there a positive link?

Potassium Citrate Decreases Bone Resorption in Postmenopausal Women with Osteopenia: A Randomized, Double-Blind Clinical Trial

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