Clinical—Alimentary TractProton-Pump Inhibitor Use Is Not Associated With Osteoporosis or Accelerated Bone Mineral Density Loss
Section snippets
Materials and Methods
Two separate analyses were performed. In the cross-sectional study, we compared subjects with established osteoporosis, as determined by BMD testing, to controls with normal BMD. In the longitudinal study, we analyzed the change in BMD on serial assessments between PPI users and non-PPI users. The methodology used in each of these studies is described below in detail.
Results
In the cross-sectional study, 2193 subjects had evidence of osteoporosis at the hip and were matched to 5527 controls with normal hip measurements. A total of 3596 subjects had BMD measurements consistent with osteoporosis at the lumbar spine and were in turn matched to 10,257 normal controls. A description of patient demographics, BMI, medical comorbidities, and medication use is shown in Table 1.
In univariate analyses, PPI use was associated with a lower risk of osteoporosis at the lumbar
Discussion
Our results indicate that a history of chronic PPI use is not associated with an increased likelihood of having BMD in the osteoporotic range at either the hip or the lumbar spine. Furthermore, increasing intensity of PPI exposure is not associated with an increased risk of having osteoporosis. The lack of an association between PPI use and changes in BMD was further confirmed in the longitudinal assessment. An effect of PPIs on the rate of bone mineral loss was also not detected among subjects
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Conflicts of interest The authors disclose the following: Dr Laura Targownik has served on advisory boards for Janssen-Ortho Canada and Astra-Zeneca Canada and on the speaker's bureau for Astra-Zeneca Canada. Both companies either currently or at one time marketed particular proton pump inhibitors in Canada. The remaining authors disclose no conflicts.
Funding Dr Targownik is supported by a Canadian Institutes of Health Research New Investigator Grant in Osteoporosis, and by Osteoporosis Canada. Dr Leslie is supported by the Canadian Institutes of Health Research. Dr Lix is supported by a CIHR New Investigator Award. This project was funded by a grant from the Canadian Institutes of Health Research Regional Partnership Program and the Manitoba Health Research Council.