*Review* **Role of Citrate in Pathophysiology and Medical Management of Bone Diseases**

#### **Donatella Granchi 1,\*, Nicola Baldini 1,2, Fabio Massimo Ulivieri 3 and Renata Caudarella 4**


Received: 23 September 2019; Accepted: 22 October 2019; Published: 25 October 2019

**Abstract:** Citrate is an intermediate in the "Tricarboxylic Acid Cycle" and is used by all aerobic organisms to produce usable chemical energy. It is a derivative of citric acid, a weak organic acid which can be introduced with diet since it naturally exists in a variety of fruits and vegetables, and can be consumed as a dietary supplement. The close association between this compound and bone was pointed out for the first time by Dickens in 1941, who showed that approximately 90% of the citrate bulk of the human body resides in mineralised tissues. Since then, the number of published articles has increased exponentially, and considerable progress in understanding how citrate is involved in bone metabolism has been made. This review summarises current knowledge regarding the role of citrate in the pathophysiology and medical managemen<sup>t</sup> of bone disorders.

**Keywords:** bone metabolism; bone mineral density; bone remodelling; citrate supplement; osteopenia; osteoporosis; kidney diseases
