Panacea Index Logo

Command Palette

Search for a command to run...

Glucocorticoid activity and metabolism with NaCl-induced low-grade metabolic acidosis and oral alkalization: results of two randomized controlled trials.

Endocrine
April 1, 2016
Judith Buehlmeier et al. (5 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to investigate the effects of alkaline supplementation and sodium chloride (NaCl)-induced low-grade metabolic acidosis on glucocorticoid activity and metabolism.

Results Summary

Alkaline supplementation (KHCO3) reduced markers of adrenal glucocorticoid secretion and bioactive-free glucocorticoids, but NaCl reduction did not show the expected fall in glucocorticoid activity when net acid excretion increased. Diet-induced acidification/alkalization affects glucocorticoid metabolism, potentially contributing to bone degradation and cardiometabolic risks.

Population

Eight young, healthy, normal-weight men.

Effective Dosage

High NaCl diet (32 g/day in Study A, 31 g/day in Study B), low NaCl diet (3 g/day in Study B), supplemented with 90 mmol KHCO3/day in Study A.

Duration

10 days per intervention in Study A, 14 days per intervention in Study B.

Interactions

None mentioned.

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
high dietary acid load
increase
bone and protein catabolism
-
-
has been shown to increase
#1
sodium chloride (NaCl) intake
increase
bone and protein catabolism
-
-
has been shown to increase
#2
supplementation of 90 mmol KHCO3
decrease
marker of total adrenal GC secretion (THF + 5α-THF + THE)
eight young, healthy, normal-weight men
-
dropped
#3
supplementation of 90 mmol KHCO3
decrease
potentially bioactive-free GCs (urinary-free cortisol + free cortisone)
eight young, healthy, normal-weight men
-
reduced
#4
NaCl-reduction
no change
GC secretion
eight young, healthy, normal-weight men
-
did not exhibit the expected fall
#5
NaCl-reduction
no change
potentially bioactive-free GCs
eight young, healthy, normal-weight men
-
did not exhibit the expected fall
#6
NaCl-reduction
increase
net acid excretion
eight young, healthy, normal-weight men
30 mEq/d
was raised
#7
Diet-induced acidification/alkalization
neutral
GC activity and metabolism
-
-
affects
#8
long-term ingestion of habitually acidifying western diets
increase
bone degradation and cardiometabolic diseases
-
-
may constitute an independent risk factor for
#9
Abstract

Low-grade metabolic acidosis (LGMA), as induced by high dietary acid load or sodium chloride (NaCl) intake, has been shown to increase bone and protein catabolism. Underlying mechanisms are not fully understood, but from clinical metabolic acidosis interactions of acid-base balance with glucocorticoid (GC) metabolism are known. We aimed to investigate GC activity/metabolism under alkaline supplementation and NaCl-induced LGMA. Eight young, healthy, normal-weight men participated in two crossover designed interventional studies. In Study A, two 10-day high NaCl diet (32 g/d) periods were conducted, one supplemented with 90 mmol KHCO3/day. In Study B, participants received a high and a low NaCl diet (31 vs. 3 g/day), each for 14 days. During low NaCl, the diet was moderately acidified by replacement of a bicarbonate-rich mineral water (consumed during high NaCl) with a non-alkalizing drinking water. In repeatedly collected 24-h urine samples, potentially bioactive-free GCs (urinary-free cortisol + free cortisone) were analyzed, as well as tetrahydrocortisol (THF), 5α-THF, and tetrahydrocortisone (THE). With supplementation of 90 mmol KHCO3, the marker of total adrenal GC secretion (THF + 5α-THF + THE) dropped (p = 0.047) and potentially bioactive-free GCs were reduced (p = 0.003). In Study B, however, GC secretion and potentially bioactive-free GCs did not exhibit the expected fall with NaCl-reduction as net acid excretion was raised by 30 mEq/d. Diet-induced acidification/alkalization affects GC activity and metabolism, which in case of long-term ingestion of habitually acidifying western diets may constitute an independent risk factor for bone degradation and cardiometabolic diseases.

Medical Subject Headings (MeSH)
Acid-Base EquilibriumAcidosisAdultAlkaliesBicarbonatesCortisoneCross-Over StudiesDietDrinking WaterGlucocorticoidsHumansHydrocortisoneMalePotassium CompoundsSodium ChlorideTetrahydrocortisolTetrahydrocortisoneYoung Adult
Study Links
Quality Scores
Safety60
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations19
Citations/Year2.1
Relative Citation Ratio0.95
NIH Percentile48.3%
Research Impact Scores
APT Score0.75
Weight Score1.93
Normalized Score0.71
Related Supplements
Glucocorticoid activity and metabolism with NaCl-induced low... | Panacea Index