Abstract
BACKGROUND:
Proton pump inhibitors (PPIs) are widely used drugs for the treatment of many diseases. Prolonged use was believed to have an effect on bone mineral metabolism.
OBJECTIVE:
To investigate the effect of PPIs on bone mineral density and to identify risk factors affecting bone mineral density among users of PPIs.
PATIENTS AND METHODS:
A cross sectional study was conducted in Rheumatology Consultancy Clinic of Baghdad Teaching Hospital /Baghdad Medical City during the period from 1st of November, 2017 to 31st of October, 2018 on convenient sample of 100 patients were selected; first group was 50 PPI users and 50 PPI non-users. The bone mineral density of patients was assessed using dual energy x-ray absorptiometry (DXA) scan.
RESULTS:
A significant reduction in serum calcium, vitamin D and serum inorganic phosphorus levels of PPIs users with elevated level of alkaline phosphatase activity. All scores of DXA scan like T-scores L2-L4, Z-scores L2-L4 and total scores were significantly reduced among PPIs users in comparison to PPIs-non users (P<0.05).
CONCLUSION:
The proton pump inhibitors have a profound effect on bone mineral density and long term use of proton pump inhibitors is commonly related with osteoporosis and osteopenia development of lumbar spines.
Keywords
10. Rozgony NR. Vitamin B (12) deficiency is linked with long-term use of proton pump inhibitors in institutionalized older adults: 79 could a cyanocobalamin nasal spray be beneficial? J Nutr Elder 2010; 29:87–99.
11. Sampathkumar K, Ramalingam R, Prabakar A, Abraham A. Acute interstitial nephritis due to proton pump inhibitors. Indian J Nephrol 2013; 23(4):304-307.
12. Lau AN, Tomizza M, Wong-Pack M, Papaioannou A, Adachi JD. The relationship between long-term proton pump inhibitor therapy and skeletal frailty. Endocrine 2015; 49:606-10.
13. Yang X-Y. Chronic proton pump inihibitor therapy and calcium metabolism. Curr Gastroenterol Rep 2012; 14:473-79.
14. Hansen KE, Jones AN, Lindstrom MJ, Davis LA, Ziegler TE, Penniston KL, et al. Do proton pump inhibitors decrease calcium absorption? J Bone Miner Res 2010; 25:2786-95.
15. Costa-Rodrigues J, Reis S, Teixeira S, Lopes S, Fernandes MH. Dose-dependent inhibitory effects of proton pump inhibitors on human osteoclastic and osteoblastic cell activity. FEBS J 2013; 280:5052-64.
16. Jo Y, Park E, Ahn SB, Jo YK, Son B, Kim SH, et al. A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study. Gut Liver 2014; 9:607-14.
17. Ozdil K, Kahraman R, Sahin A, Calhan T, Gozden EH, Akyuz U, et al. Bone density in proton pump inhibitors users: a prospective study. Rheumatol Int 2013; 33:2255-60.
18. Rexhepi S, Bahtiri E, Rexhepi M, Sahatciu-Meka V, Rexhepi B. Association of Body Weight and Body Mass Index with Bone Mineral Density in Women and Men from Kosovo. Mater Sociomed 2015; 27:259-62.
19. Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep 2010; 12:448-57.
20. Al-Zahrany AA, AL Mourgi M. Risk of Osteoporosis and Osteopenia in Patients with Prolonged Use of Proton Pump Inhibitors. The Egyptian Journal of Hospital Medicine 2016; 65: 643- 647.
21. Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategies. Ther Adv Musculoskelet Dis 2014; 6:185-202.
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