Effects of potassium citrate or potassium chloride in patients with combined glucose intolerance: A placebo-controlled pilot study

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• 作者：Katrin Conen^a ; Roberto Scanni^a ; Marie-Therese Gombert^a ; Henry N. Hulter^b ; Reto Krapf^a ; ^{Reto.krapf@hirslanden.ch" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Combined glucose intolerance ; Prediabetes ; Potassium ; Metabolic acidosis ; Citrate
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：30
• 期：6
• 页码：1158-1161
• 全文大小：208 K

文摘

Experimental K⁺ depletion reversibly inhibits insulin secretion, while chronic metabolic acidosis decreases insulin sensitivity. We aimed to investigate the effects of potassium supplementation and alkali supplementation in non-acidotic, normokalemic humans with combined glucose intolerance.

Study design and results

In this double-blind, placebo-controlled study in 11 subjects (7 male, 4 female, ages 47–63 years), 90 meqs of oral KCl or Kcitrate per day for 2 weeks each increased insulin production as measured by homeostasis model assessment Beta [KCl = 86 (CI 81–91), Kcitrate = 88 (82–94), placebo = 78 (73–83)%, p < 0.04], but only Kcitrate attenuated insulin resistance as assessed by HOMA-IR (insulin resistance, Kcitrate = 2.8 (2.5–3.1), placebo = 3.2 (2.9–3.5), p < 0.03) and only Kcitrate increased quantitative insulin sensitivity check index (Quicki, Kcitrate = 0.355 (0.305–0.405), placebo = 0.320 (0.265–0.375) p < 0.04). These results were confirmed by independent measurements, i.e. HOMA C-peptide and whole body insulin sensitivity index measured during oral glucose tolerance testing. Kcitrate significantly decreased systolic and diastolic 24-hour ambulatory blood pressures (− 4.0 (− 3 to − 5) and − 2.7 (− 1.9 to − 3.5), respectively as compared to placebo, p < 0.02) while KCl was without a significant effect.

Conclusions

K⁺ supplementation in the absence of overt K⁺ depletion improves beta-cell function in subjects with combined glucose intolerance. The insulin-sensitizing and hypotensive effect, however, depend on citrate as the accompanying anion.