Universität zu Köln

Esche, Jonas, Johner, Simone, Shi, Lijie, Schoenau, Eckhard and Remer, Thomas (2016). Urinary Citrate, an Index of Acid-Base Status, Predicts Bone Strength in Youths and Fracture Risk in Adult Females. J. Clin. Endocrinol. Metab., 101 (12). S. 4914 - 4922. WASHINGTON: ENDOCRINE SOC. ISSN 1945-7197

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Abstract

Context: Diet can impact on bone strength via metabolic shifts in acid-base status. In contrast to the strongly diet-dependent biomarker urinary potential renal acid load (uPRAL), the amount of renally excreted citrate integrates nutritional and systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization. Objective: To examine the association between urinary citrate excretion and bone strength as well as long-term fracture risk. Design and Participants: Prospective cross-sectional analysis; 231 healthy children (6-18 y) of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study were included, with at least 2 urine collections available during the 4 years preceding peripheral quantitative computed tomography (pQCT) of the nondominant proximal forearm. uPRAL, urinary citrate, and urinary nitrogen excretion were quantified in 857 24-hour urine samples. Data on overall fracture incidence were collected within a 15-year follow-up after pQCT measurement. Main Outcome Measures: Parameters of bone quality and geometry (pQCT) as well as long-term fracture incidence. Results: After controlling for confounders, especially forearm length, muscle area, and urinary nitrogen (biomarker of protein intake), urinary citrate excretion was positively associated with various parameters of bone quality and geometry (P=.05). Fracture risk in adult females, but not in males, was inversely associated with urinary citrate and positively with uPRAL (P=.05). Conclusions: Although urinary citrate has to be confirmed as an integrated noninvasive biomarker of systemic acid-base status in further studies, our results substantiate dietary and metabolic acidity as potentially adverse for bone health in the long run from childhood onward.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Esche, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Johner, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Shi, Lijie UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, Eckhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Remer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-254864
DOI:	10.1210/jc.2016-2677
Journal or Publication Title:	J. Clin. Endocrinol. Metab.
Volume:	101
Number:	12
Page Range:	S. 4914 - 4922
Date:	2016
Publisher:	ENDOCRINE SOC
Place of Publication:	WASHINGTON
ISSN:	1945-7197
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUANTITATIVE COMPUTED-TOMOGRAPHY; METABOLIC-ACIDOSIS; PROXIMAL RADIUS; HEALTHY-CHILDREN; POTASSIUM CITRATE; PROTEIN-INTAKE; WESTERN DIET; EXCRETION; LOAD; RATS Multiple languages Endocrinology & Metabolism Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25486