Do Proton Pump Inhibitors Decrease Calcium Absorption?

被引:98
作者
Hansen, Karen E. [1 ]
Jones, Andrea N.
Lindstrom, Mary J. [2 ,3 ]
Davis, Lisa A. [4 ]
Ziegler, Toni E. [5 ]
Penniston, Kristina L. [6 ]
Alvig, Amy L.
Shafer, Martin M. [7 ]
机构
[1] Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Ctr Clin Sci, Madison, WI 53792 USA
[2] Dept Biostat, Madison, WI USA
[3] Dept Med Informat, Madison, WI USA
[4] Ctr Translat & Clin Res Core, Madison, WI USA
[5] Univ Wisconsin, Natl Primate Res Ctr, Madison, WI 53792 USA
[6] Univ Wisconsin, Dept Urol, Madison, WI 53792 USA
[7] Univ Wisconsin, Wisconsin State Lab Hyg, Madison, WI 53706 USA
关键词
ACID SUPPRESSANT; BONE; CALCIUM ABSORPTION; FRACTURE OSTEOPOROSIS; GASTRIC-ACID SECRETION; TERM OMEPRAZOLE TREATMENT; BONE TURNOVER; HIP FRACTURE; SUPPRESSION THERAPY; DIETARY-PROTEIN; STABLE-ISOTOPES; OLDER-ADULTS; RISK; WOMEN;
D O I
10.1002/jbmr.166
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Proton pump inhibitors (PPIs) increase osteoporotic fracture risk presumably via hypochlorhydria and consequent reduced fractional calcium absorption (FCA) Existing studies provide conflicting information regarding the direct effects of PPIs on FCA We evaluated the effect of PPI therapy on FCA We recruited women at least 5 years past menopause who were not taking acid suppressants Participants underwent three 24-hour inpatient FCA studies using the dual stable isotope method Two FCA studies were performed 1 month apart to establish baseline calcium absorption The third study occurred after taking omeprazole (40 mg/day) for 30 days Each participant consumed the same foods during all FCA studies, study meals replicated subjects' dietary habits based on 7-day diet diaries Twenty-one postmenopausal women ages 58 +/- 7 years (mean +/- SD) completed all study visits Seventeen women were white, and 2 each were black and Hispanic FCA (mean SD) was 20% +/- 10% at visit 1, 18% +/- 10% at visit 2, and 23% +/- 10% following 30 +/- 3 days of daily omeprazole (p = 07, ANOVA) Multiple linear regression revealed that age, gastric pH, serum omeprazole levels, adherence to omeprazole, and 25-hydroxyvitamin D levels were unrelated to changes in FCA between study visits 2 and 3 The 1,25-dihydroxyvitamin D3 level at visit 2 was the only variable (p = 049) associated with the change in FCA between visits 2 and 3 PPI-associated hypochlorhydria does not decrease FCA following 30 days of continuous use Future studies should focus on identifying mechanisms by which PPIs increase the risk of osteoporotic fracture (C) 2010 American Society for Bone and Mineral Research
引用
收藏
页码:2510 / 2519
页数:10
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