This is such a bad paper. They take the NHANES data, average it for all participants, don’t bother controlling for things that have far more direct relevance to individual bicarbonate levels (e.g. diabetes, antacid use), and just assert that an observed correlation is causative.

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OutOfHere 5 hours ago | parent [-]

Complications of diabetes can lower serum bicarbonate, not increase it.

In general, it is true that there are many causes of a rise in bicarbonate, but doesn't this only makes the situation more precarious?

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timr 5 hours ago | parent | next [-]

> Whatbaoutism is not a valid excuse.

It’s not “whataboutism”. It’s a basic control in a paper that takes population data and asserts a causal link between a complex, personal biological variable and a global phenomenon.

There are probably dozens of factors that matter a lot more to individual blood gas levels than global average co2. At a minimum, I’d expect to see controls for obvious medical factors before taking this argument seriously.

	▲	OutOfHere 4 hours ago \| parent [-]
		Fair point. I can see how a global rise in antacid use could explain it more easily. If antacids are the culprit, I expect the rise in bicarbonate to eventually asymptote. Still, we know that very high sustained carbon dioxide does risk respiratory acidosis and a rise in serum bicarbonate. The question then is whether a lower sustained rise also has an observed effect. Fwiw, as per Figure 2A, thus far we see a linear increase in the data, with no sign of it being asymptotic.

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timr 5 hours ago | parent | prev [-]

[flagged]

	▲	OutOfHere 5 hours ago \| parent [-]
		Diabetic ketoacidosis causes low bicarbonate, not high.