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papers

Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss

Published: November 18, 2009
Category: Papers
Authors: Leslie WD, Leung S, Lix LM, Targownik LE
Country: Canada
Language: null
Type: Care Management
Setting: Academic

Gastroenterology 138:896-904.

Section of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada

BACKGROUNDS and AIMS: Recent studies have shown an association between proton-pump inhibitor use (PPI) and hip fracture. The mechanism by which PPI use promotes the development of hip fracture is uncharacterized. Therefore, we sought to determine whether PPI use is associated with osteoporosis or accelerated bone mineral density (BMD) loss.

METHODS: We used the Manitoba Bone Mineral Density Database to determine the relationship between chronic PPI use and osteoporosis on an initial assessment of BMD and on BMD loss between successive assessments of BMD. In the cross-sectional study, cases with osteoporosis at the hip or lumbar vertebrae (T-score or =-1.0). In the longitudinal analysis, the change in BMD among PPI users and nonusers between successive BMD assessments was assessed. Conditional logistic regression and multivariate linear regression were used to obtain estimates of the association between PPI use and osteoporosis and of the annualized change in BMD associated with PPI use.

RESULTS: PPI use was not associated with having osteoporosis at either the hip (OR, 0.84; 95% CI, 0.55-1.34) or the lumbar spine (OR, 0.79; 95% CI, 0.59-1.06) for PPI use >1500 doses over the previous 5 years. In the longitudinal study no significant decrease was observed in BMD at either site attributable to PPI use.

CONCLUSIONS: PPI use does not appear to be associated with either the presence of osteoporosis or accelerated BMD loss. The association between PPI use and hip fracture is probably related to factors independent of osteoporosis.

PMID: 19931262

High-Impact Chronic Conditions,Population Markers,Co-morbidity,Canada,Absorptiometry,Photon,Aged,80 and over,Cross-Sectional Studies,Databases as Topic,Evidence-based Medicine,Gender,Hip Fractures/diagnostic imaging,Hip Joint/diagnostic imaging,Linear Models,Logistic Models,Longitudinal Studies,Lumbar Vertebrae/diagnostic imaging,Gender,Manitoba,Middle Aged,Odds Ratio,Osteoporosis/diagnostic imaging,Risk Assessment,Risk Factors

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