Apparently in a effort to do their job more osteoblasts become active
due the inhibition of their activity by the PPI class of medications.
The effect on balance apparently weakens the bones.
1: JAMA. 2006 Dec 27;296(24):2947-53.
Long-term proton pump inhibitor therapy and risk of hip fracture.
Yang YX, Lewis JD, Epstein S, Metz DC.
Division of Gastroenterology, Center for Clinical Epidemiology and
Biostatistics, University of Pennsylvania School of Medicine,
Philadelphia 19104, USA.
yangy@...
CONTEXT:
Proton pump inhibitors (PPIs) may interfere with calcium absorption
through induction of hypochlorhydria but they also may reduce bone
resorption through inhibition of osteoclastic vacuolar proton pumps.
OBJECTIVE:
To determine the association between PPI therapy and risk of hip
fracture.
DESIGN, SETTING, AND PATIENTS:
A nested case-control study was conducted using the
General Practice Research Database (1987-2003), which contains
information on patients in the United Kingdom. The study cohort
consisted of users of PPI therapy and nonusers of acid suppression
drugs who were older than 50 years.
Cases included all patients with an incident hip fracture. Controls
were selected using incidence density sampling, matched for sex,
index date, year of birth, and both calendar period and duration of
up-to-standard follow-up before the index date. For comparison
purposes, a similar nested case-control analysis for histamine 2
receptor antagonists was performed.
MAIN OUTCOME MEASURE:
The risk of hip fractures associated with PPI use.
RESULTS: There were 13,556 hipfracture cases and 135,386 controls.
The adjusted odds ratio (AOR) for hipfracture associated with more
than 1 year of PPI therapy was 1.44 (95%confidence interval [CI],
1.30-1.59). The risk of hip fracture was significantlyincreased among
patients prescribed long-term high-dose PPIs (AOR, 2.65; 95% CI,1.80-
3.90; P<.001). The strength of the association increased with
increasing duration of PPI therapy (AOR for 1 year, 1.22 [95% CI,
1.15-1.30]; 2 years, 1.41 [95% CI, 1.28-1.56]; 3 years, 1.54 [95% CI,
1.37-1.73]; and 4 years, 1.59 [95% CI, 1.39-1.80]; P<.001 for all
comparisons).
CONCLUSION: Long-term PPI therapy, particularly at high doses, is
associated with an increased risk of hip fracture.
PMID: 17190895 [PubMed - indexed for MEDLINE