Department of Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
Vox Sang. 2009 Nov;97(4):324-9. doi: 10.1111/j.1423-0410.2009.01202.x. Epub 2009 Jun 9.
This study aims to investigate the possible effects of acute citrate administration on bone metabolism in healthy men.
A placebo-controlled, crossover trial was conducted on 10 male volunteers. The volunteers received either a standardized infusion of citrate at 1.5 mg/kg body weight/min or the equal volume of placebo, separated by a washout period of 14 days. Serial blood and urine samples were collected and analysed for bone biochemical markers and electrolytes.
Infusion of citrate resulted in increased serum levels of the bone formation marker osteocalcin (OC) and bone resorption marker C-telopeptide of type 1 collagen (CTX). Increases in CTX and OC were positively correlated to the surge in the serum concentration of intact parathyroid hormone (iPTH) but only OC showed correlation to changes in ionized calcium. Citrate infusion showed no effect on serum concentrations of bone alkaline phosphatase, osteoprotegerin, and bone tartrate-resistant acid phosphatase 5b, or the expression of receptor activator of nuclear factor kappa B ligand. Variations in OC and CTX were short-term as both bone markers gradually declined within 90 min following citrate exposure.
Acute citrate load resulted in profound alterations of the bone markers OC and CTX. The short-term increase of CTX suggests a temporary shift to a higher bone turnover rate, although the clinical consequence of the observed changes in bone markers remains open.
本研究旨在探讨急性柠檬酸盐给药对健康男性骨代谢的可能影响。
对 10 名男性志愿者进行了安慰剂对照、交叉试验。志愿者分别接受 1.5mg/kg 体重/分钟的标准化柠檬酸盐输注或等量安慰剂，洗脱期为 14 天。连续采集血液和尿液样本，用于分析骨生化标志物和电解质。
柠檬酸盐输注导致骨形成标志物骨钙素（OC）和骨吸收标志物 1 型胶原 C 端肽（CTX）的血清水平升高。CTX 和 OC 的增加与完整甲状旁腺激素（iPTH）血清浓度的升高呈正相关，但仅 OC 与离子钙的变化相关。柠檬酸盐输注对血清骨碱性磷酸酶、骨保护素和抗酒石酸盐酸性磷酸酶 5b 浓度或核因子 kappa B 配体受体激活剂的表达均无影响。OC 和 CTX 的变化是短期的，因为两种骨标志物在柠檬酸盐暴露后 90 分钟内逐渐下降。
急性柠檬酸盐负荷导致骨标志物 OC 和 CTX 发生明显变化。CTX 的短期增加提示骨转换率暂时升高，尽管观察到的骨标志物变化的临床后果仍不确定。
