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Acid-suppressive medications and risk of bone loss and fracture in older adults.
Calcif Tissue Int 2008; 83(4):251-9CT

Abstract

Recent studies have suggested an increased fracture risk with acid-suppressive medication use. We studied two cohorts of men and women over age 65 who were enrolled in the Osteoporotic Fractures in Men Study (MrOS) and the Study of Osteoporotic Fractures (SOF), respectively. We used dual-energy X-ray absorptiometry and assessed baseline use of proton pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs) in 5,755 men and 5,339 women. Medication use and bone mineral density (BMD) were assessed, and hip and other nonspine fractures were documented. On multivariate analysis, men using either PPIs or H2RAs had lower cross-sectional bone mass. No significant BMD differences were observed among women. However, there was an increased risk of nonspine fracture among women using PPIs (relative hazard [RH] = 1.34, 95% confidence interval [CI] 1.10-1.64). PPI use was also associated with an increased risk of nonspine fracture in men but only among those who were not taking calcium supplements (RH = 1.49, 95% CI 1.04-2.14). H2RA use was not associated with nonspine fractures, and neither H2RA use nor PPI use was associated with incident hip fractures in men or women. The use of PPIs in older women, and perhaps older men with low calcium intake, may be associated with a modestly increased risk of nonspine fracture.

Authors+Show Affiliations

Endocrine Division, Massachusetts General Hospital, Thier 1101, 50 Blossom Street, Boston, MA 02114, USA. ewyu@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18813868

Citation

Yu, Elaine W., et al. "Acid-suppressive Medications and Risk of Bone Loss and Fracture in Older Adults." Calcified Tissue International, vol. 83, no. 4, 2008, pp. 251-9.
Yu EW, Blackwell T, Ensrud KE, et al. Acid-suppressive medications and risk of bone loss and fracture in older adults. Calcif Tissue Int. 2008;83(4):251-9.
Yu, E. W., Blackwell, T., Ensrud, K. E., Hillier, T. A., Lane, N. E., Orwoll, E., & Bauer, D. C. (2008). Acid-suppressive medications and risk of bone loss and fracture in older adults. Calcified Tissue International, 83(4), pp. 251-9. doi:10.1007/s00223-008-9170-1.
Yu EW, et al. Acid-suppressive Medications and Risk of Bone Loss and Fracture in Older Adults. Calcif Tissue Int. 2008;83(4):251-9. PubMed PMID: 18813868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acid-suppressive medications and risk of bone loss and fracture in older adults. AU - Yu,Elaine W, AU - Blackwell,Terri, AU - Ensrud,Kristine E, AU - Hillier,Teresa A, AU - Lane,Nancy E, AU - Orwoll,Eric, AU - Bauer,Douglas C, Y1 - 2008/09/24/ PY - 2008/06/18/received PY - 2008/08/15/accepted PY - 2008/9/25/pubmed PY - 2009/7/10/medline PY - 2008/9/25/entrez SP - 251 EP - 9 JF - Calcified tissue international JO - Calcif. Tissue Int. VL - 83 IS - 4 N2 - Recent studies have suggested an increased fracture risk with acid-suppressive medication use. We studied two cohorts of men and women over age 65 who were enrolled in the Osteoporotic Fractures in Men Study (MrOS) and the Study of Osteoporotic Fractures (SOF), respectively. We used dual-energy X-ray absorptiometry and assessed baseline use of proton pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs) in 5,755 men and 5,339 women. Medication use and bone mineral density (BMD) were assessed, and hip and other nonspine fractures were documented. On multivariate analysis, men using either PPIs or H2RAs had lower cross-sectional bone mass. No significant BMD differences were observed among women. However, there was an increased risk of nonspine fracture among women using PPIs (relative hazard [RH] = 1.34, 95% confidence interval [CI] 1.10-1.64). PPI use was also associated with an increased risk of nonspine fracture in men but only among those who were not taking calcium supplements (RH = 1.49, 95% CI 1.04-2.14). H2RA use was not associated with nonspine fractures, and neither H2RA use nor PPI use was associated with incident hip fractures in men or women. The use of PPIs in older women, and perhaps older men with low calcium intake, may be associated with a modestly increased risk of nonspine fracture. SN - 1432-0827 UR - https://www.unboundmedicine.com/medline/citation/18813868/Acid_suppressive_medications_and_risk_of_bone_loss_and_fracture_in_older_adults_ L2 - https://dx.doi.org/10.1007/s00223-008-9170-1 DB - PRIME DP - Unbound Medicine ER -