Associations between Proton Pump Inhibitor and Histamine-2 Receptor Antagonist and Bone Mineral Density among Kidney Transplant Recipients.

In the general population, use of proton pump inhibitor (PPI) has been linked to higher risk of osteoporotic fractures. PPI is commonly prescribed in kidney transplant recipients (KTRs). However, the effect of PPI on osteoporosis in KTRs is largely unstudied. A total of 1,774 adult KTRs in the Wisconsin Allograft Recipient Database with at least one eligible bone mineral density (BMD) measurement at least 3 months after transplantation were included in the analyses. Associations between use of PPI and histamine-2 receptor antagonist (H2RA) at 3 months after transplantation and subsequent slope of T-score were assessed. A total of 1,478 (83.3%) participants were using a PPI at 3 months after transplantation. Compared to the use of H2RA, use of PPI was not significantly associated with annualized slope of hip T-score (β = -0.0039, 95% CI -0.00497 to 0.0021) or annualized slope of spine T-score (β = -0.017, 95% CI -0.049 to 0.083) after adjustment for potential confounders. Similarly, no significant association between use of PPI and slope of T-score was observed when defining PPI/H2RA exposure as use within 6 months of the initial BMD measurement, or only including participants with at least 2 BMD measurements, or stratified by different age and sex. Use of PPI was not associated with an increased rate of BMD loss in KTRs. Our results support previous findings that PPI use does not have a significant effect on bone mineral loss.

Lyu B ，Hansen KE ，Jorgenson MR ，Astor BC ... -  《-》

Proton Pump Inhibitors, But Not H2-receptor Antagonists, Are Associated With Incident Fractures Among Kidney Transplant Recipients.

Lyu B ，Jorgenson MR ，Hansen KE ，Djamali A ，Astor BC ... -  《-》

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

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. 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 =-2.5) were matched to 3 controls with normal BMD (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. 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. 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.

Targownik LE ，Lix LM ，Leung S ，Leslie WD ... -  《-》

Comparing proton pump inhibitors with histamin-2 receptor blockers regarding the risk of osteoporotic fractures: a nested case-control study of more than 350,000 Korean patients with GERD and peptic ulcer disease.

Park JH ，Lee J ，Yu SY ，Jung JH ，Han K ，Kim DH ，Rhee J ... -  《BMC Geriatrics》

Proton pump inhibitors use and change in bone mineral density.

Limited data are available reporting the effect of proton pump inhibitor (PPI) use on changes in bone mineral density (BMD). The aim of this study was to investigate the relationship between PPI use and BMD. The current cross-sectional study included 80 patients (31 male and 49 female) aged 20-45 years old without history of hip fracture with a follow-up of at least 2 years. The study was carried out in 40 daily PPI users and 40 PPI non-users. Femur and posterior-anterior spine BMD were quantified by dual-energy X-ray absorptiometry in all participants. The relationship between use of PPI and BMD was tested by multivariate linear regression analysis adjusted for age, sex, BMI and serum vitamin D levels. Our study demonstrated that mean femoral T-scores were significant between PPI and non-user groups (-0.44 ± 1.11 vs. +0.19 ± 0.95, P = 0.007). In addition, the frequency of femoral osteoporosis and osteopenia in the exposed group was significantly more in the control group (P = 0.04). Mean femoral Z-scores, lumbar spine T-score and lumbar spine Z-score were not statistically different between PPI and non-user groups. The linear regression analysis revealed that there was no association between PPI and non-users, and lumbar spine T-score. Overall, the results of this study showed that PPI use in subjects without risk factors of osteoporosis determined by the femoral T-score compared with the control group was associated with increased risk of developing osteoporosis and osteopenia in the femur bones.

Arj A ，Razavi Zade M ，Yavari M ，Akbari H ，Zamani B ，Asemi Z ... -  《-》