3-Hydroxybutyrate administration elevates plasma parathyroid hormone in a pilot human randomized, controlled, cross...

Area of Science:

• Endocrinology
• Bone Metabolism
• Nutritional Ketosis

Background:

• Ketone bodies, like 3-hydroxybutyrate (3OHB), have significant energetic and signaling roles.
• Emerging evidence links ketogenic diets, fasting, and SGLT2 inhibitors to hyperparathyroidism and compromised bone health.

Purpose of the Study:

• To investigate the effects of exogenous 3OHB administration on bone metabolism.
• To specifically assess the impact on parathyroid hormone (PTH) and calcium-phosphate homeostasis.

Main Methods:

• A randomized, controlled, cross-over study involving eight healthy participants aged 50-70 years.
• Participants received either continuous intravenous DL-3OHB-NaCl or saline infusion for 390 minutes.
• Measured outcomes included PTH, calcium, phosphate, CTX, and PINP levels.

Main Results:

• 3OHB infusion led to a 25% increase in PTH concentration and a 30% decrease in phosphate levels.
• Bone resorption marker CTX increased by 5% following 3OHB administration.
• No significant changes were observed in PINP or albumin-corrected calcium levels.

Conclusions:

• Exogenous 3OHB administration elevates PTH levels and enhances bone resorption markers.
• These findings indicate a potential detrimental effect of 3OHB on bone health.
• Further research is warranted to confirm these effects on bone health in various populations.