Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality
Authors' conclusion
Chronic PPI use is associated with degraded trabecular bone quality in men, even after adjustment for BMD. No association was observed in women.
Study context
- Population
- Individuals from National Health and Nutrition Examination Survey (NHANES) 2005–2008 cycles with lumbar spine DXA scans; 3961 men, 3517 women3,961 men · 3,517 women
- Participants
- 7,478 individuals
- Exposure
- Chronic PPI use vs no chronic PPI use
- Outcome
- Trabecular bone microarchitecture assessed by TBS
Methodological detailspopulation-based, NHANES 2005–2008, multivariable linear regression stratified by sex
- Population-based
- NHANES 2005–2008
- Multivariable linear regression stratified by sex
Main finding
As reported in the abstract
TBS
Chronic PPI use vs No chronic PPI useEstimate (95% CI)P value
Lower TBS in men; adjusted for confounders
difference (men) −0.039(−0.058 to −0.020)
P < 0.001TBS
difference (men, further adjusted for lumbar spine and femoral neck BMD) −0.026(−0.039 to −0.012)
P = 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| BMD T-scores, menChronic PPI use vs No chronic PPI use · adjusted for relevant confounders | difference in lumbar spine T-score −0.27 (95% CI −0.51 to −0.04) | P = 0.023 |
| BMD T-scores, menChronic PPI use vs No chronic PPI use · adjusted for relevant confounders | difference in total hip T-score −0.21 (95% CI −0.41 to −0.01) | P = 0.041 |
| BMD T-scores, menChronic PPI use vs No chronic PPI use · adjusted for relevant confounders | difference in femoral neck T-score −0.22 (95% CI −0.44 to −0.00) | P = 0.047 |
Bone mineral density (BMD), women
- No significant association between chronic PPI use and BMD in women
Original publication
Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality. J Clin Endocrinol Metab. Published 28 August 2024. doi:10.
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