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Proton pump inhibitors therapy and the risk of hip fracture in older people in Taiwan

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Abstract

Introduction

Conflicting results exist on the relationship between proton pump inhibitors use and hip fracture in old people. The objective of the paper was to explore this issue in Taiwan.

Methods

We conducted a population-based case–control study using the database of the Taiwan National Health Insurance Program. Cases included subjects aged 65 years and over with newly diagnosed hip fracture between 2000 and 2013 (n = 7208). Controls included subjects aged 65 years and over without a diagnosis of hip fracture (n = 7208). The cases and the controls were matched with sex, age, comorbidities, and index year of diagnosing hip fracture. The odds ratio and 95% confidence interval for hip fracture associated with proton pump inhibitors use were estimated by the multivariable logistic regression model.

Results

The adjusted odds ratio of hip fracture was 0.96 for subjects with current use of proton pump inhibitors (95% confidence interval 0.76, 1.22), 1.17 for subjects with recent use (95% confidence interval 0.90, 1.52), and 1.12 for subjects with late use (95% confidence interval 0.91, 1.38), compared with never use.

Conclusions

No significant association can be detected between proton pump inhibitors use and the risk of hip fracture in older people in Taiwan.

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References

  1. Shin JM, Sachs G (2008) Pharmacology of proton pump inhibitors. Curr Gastroenterol Rep 10:528–534

    Article  PubMed  PubMed Central  Google Scholar 

  2. Robinson M, Horn J (2003) Clinical pharmacology of proton pump inhibitors: what the practising physician needs to know. Drugs 63:2739–2754

    Article  CAS  PubMed  Google Scholar 

  3. Maes ML, Fixen DR, Linnebur SA (2017) Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence. Ther Adv Drug Saf. 8:273–297

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wilhelm SM, Rjater RG, Kale-Pradhan PB (2013) Perils and pitfalls of long-term effects of proton pump inhibitors. Expert Rev Clin Pharmacol 6:443–451

    Article  CAS  PubMed  Google Scholar 

  5. Cheng KC, Liao KF, Lin CL, Lai SW (2017) Correlation of proton pump inhibitors with pulmonary tuberculosis: a case-control study in Taiwan. Front Pharmacol 8:481

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lin HF, Liao KF, Chang CM, Lin CL, Lai SW (2017) Correlation between proton pump inhibitors and risk of pyogenic liver abscess. Eur J Clin Pharmacol 73:1019–1025

    Article  CAS  PubMed  Google Scholar 

  7. Hung SC, Liao KF, Hung HC, Lin CL, Lai SW, Lee PC et al (2017) Using proton pump inhibitors correlates with an increased risk of chronic kidney disease: a nationwide database-derived case–controlled study. Fam Pract. https://doi.org/10.1093/fampra/cmx102

    PubMed  Google Scholar 

  8. Yang YX, Lewis JD, Epstein S, Metz DC (2006) Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 296:2947–2953

    Article  CAS  PubMed  Google Scholar 

  9. Ngamruengphong S, Leontiadis GI, Radhi S, Dentino A, Nugent K (2011) Proton pump inhibitors and risk of fracture: a systematic review and meta-analysis of observational studies. Am J Gastroenterol. 106:1209–1218

    Article  CAS  PubMed  Google Scholar 

  10. Ding J, Heller DA, Ahern FM, Brown TV (2014) The relationship between proton pump inhibitor adherence and fracture risk in the elderly. Calcif Tissue Int 94:597–607

    Article  CAS  PubMed  Google Scholar 

  11. Khalili H, Huang ES, Jacobson BC, Camargo CA Jr, Feskanich D, Chan AT (2012) Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. BMJ 344:e372

    Article  PubMed  PubMed Central  Google Scholar 

  12. Reyes C, Formiga F, Coderch M, Hoyo J, Ferriz G, Casanovas J et al (2013) Use of proton pump inhibitors and risk of fragility hip fracture in a Mediterranean region. Bone 52:557–561

    Article  CAS  PubMed  Google Scholar 

  13. Gray SL, LaCroix AZ, Larson J, Robbins J, Cauley JA, Manson JE et al (2010) Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative. Arch Intern Med 170:765–771

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kaye JA, Jick H (2008) Proton pump inhibitor use and risk of hip fractures in patients without major risk factors. Pharmacotherapy 28:951–959

    Article  CAS  PubMed  Google Scholar 

  15. Chan DC, Lee YS, Wu YJ, Tsou HH, Chen CT, Hwang JS et al (2013) A 12-year ecological study of hip fracture rates among older Taiwanese adults. Calcif Tissue Int 93:397–404

    Article  CAS  PubMed  Google Scholar 

  16. Lin CM, Liao KF, Lin CL, Lai SW (2017) Use of simvastatin and risk of acute pancreatitis: a nationwide case–control study in Taiwan. J Clin Pharmacol 57:918–923

    Article  CAS  PubMed  Google Scholar 

  17. Hsu FG, Sheu MJ, Lin CL, Hsieh YW, Lai SW (2017) Use of zolpidem and risk of acute pyelonephritis in women: a population-based case-control study in Taiwan. J Clin Pharmacol 57:376–381

    Article  CAS  PubMed  Google Scholar 

  18. Lai SW, Lin CL, Liao KF (2017) Population-based cohort study investigating the association between weight loss and pyogenic liver abscesses. Biomedicine 7:38–43

    Google Scholar 

  19. Wu MH, Lee TH, Lee HP, Li TM, Lee IT, Shieh PC et al (2017) Kuei-Lu-Er-Xian-Jiao extract enhances BMP-2 production in osteoblasts. Biomedicine-Taiwan 7:9–15

    Article  Google Scholar 

  20. Wen YJ, Yin MC (2017) The anti-inflammatory and anti-glycative effects of rosmarinic acid in the livers of type 1 diabetic mice. Biomedicine 7:37–41

    Article  Google Scholar 

  21. Pan CC, Huang HL, Chen MC, Kung CY, Kung PT, Chou WY et al (2017) Lower risk of end stage renal disease in diabetic nurse. Biomedicine-Taiwan 7:29–37

    Article  Google Scholar 

  22. Yang MD, Lin KC, Lu MC, Jeng LB, Hsiao CL, Yueh TC et al (2017) Contribution of matrix metalloproteinases-1 genotypes to gastric cancer susceptibility in Taiwan. Biomedicine-Taiwan 7:18–24

    Article  Google Scholar 

  23. Yang JS, Lu CC, Kuo SC, Hsu YM, Tsai SC, Chen SY et al (2017) Autophagy and its link to type II diabetes mellitus. Biomedicine-Taiwan 7:1–12

    Article  Google Scholar 

  24. Liu YL, Liu JH, Wang IK, Ju SW, Yu TM, Chen IR et al (2017) Association of inflammatory cytokines with mortality in peritoneal dialysis patients. Biomedicine-Taiwan 7:1–8

    Article  Google Scholar 

  25. Lin CH, Lin WC, Chang JS (2017) Presentations and management of different causes of chylothorax in children: one medical center’s experience. Biomedicine-Taiwan 7:30–34

    Article  Google Scholar 

  26. Liao CF, Yang TY, Chen YH, Yao CH, Way TD, Chen YS (2017) Effects of swimming exercise on nerve regeneration in a rat sciatic nerve transection model. Biomedicine-Taiwan 7:16–24

    Article  Google Scholar 

  27. Liang YC, Hu JC, Li PY, Huang GJ, Kuo YH, Chao CY (2017) Torenia concolor Lindley var. formosana Yamazaki extracts improve inflammatory response and lipid accumulation via PPARs activation. Biomedicine 7:29–36

    Article  Google Scholar 

  28. Lee MR, Lin C, Lu CC, Kuo SC, Tsao JW, Juan YN et al (2017) YC-1 induces G0/G1 phase arrest and mitochondria-dependent apoptosis in cisplatin-resistant human oral cancer CAR cells. Biomedicine-Taiwan 7:31–42

    Article  Google Scholar 

  29. Lin WC, Lin CH (2016) Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department. Biomedicine-Taiwan 6:20–24

    Article  Google Scholar 

  30. Huang YP, Chang NW (2016) PPARalpha modulates gene expression profiles of mitochondrial energy metabolism in oral tumorigenesis. Biomedicine-Taiwan 6:17–22

    Article  Google Scholar 

  31. Hsu YM, Yin MC (2016) EPA or DHA enhanced oxidative stress and aging protein expression in brain of d-galactose treated mice. Biomedicine-Taiwan 6:23–30

    Article  Google Scholar 

  32. Hsieh TC, Wu YC, Sun SS, Yen KY, Kao CH (2016) Treating hepatocellular carcinoma with 90Y-bearing microspheres: a review. Biomedicine-Taiwan 6:1–7

    Article  Google Scholar 

  33. Chen YF, Wu KJ, Huang WS, Hsieh YW, Wang YW, Tsai HY et al (2016) Neuroprotection of Gueichih-Fuling-Wan on cerebral ischemia/reperfusion injury in streptozotocin-induced hyperglycemic rats via the inhibition of the cellular apoptosis pathway and neuroinflammation. Biomedicine-Taiwan 6:15–23

    Article  Google Scholar 

  34. Ministry of Health and Welfare Taiwan. 2016 Taiwan Health and Welfare Report. http://www.mohw.gov.tw. [cited on July 1, 2017, English version]

  35. Hung SC, Lin CH, Hung HC, Lin CL, Lai SW (2017) Use of selective serotonin reuptake inhibitors and risk of hip fracture in the elderly: a case–control study in Taiwan. J Am Med Dir Assoc. 18:350–354

    Article  PubMed  Google Scholar 

  36. Lai SW, Liao KF, Liao CC, Muo CH, Liu CS, Sung FC (2010) Polypharmacy correlates with increased risk for hip fracture in the elderly: a population-based study. Medicine 89:295–299

    Article  PubMed  Google Scholar 

  37. Lai SW, Lin CL, Liao KF (2017) Use of oral corticosteroids and risk of hip fracture in the elderly in a case–control study. Front Pharmacol 8:625

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lai SW, Lin CL, Chen WC, Liao KF (2015) Correlation between use of zopiclone and risk of hip fracture in elderly adults: a case–control study in Taiwan. J Am Geriatr Soc 63:2534–2537

    Article  PubMed  Google Scholar 

  39. Lin HF, Liao KF, Chang CM, Lin CL, Lin CH, Lai SW (2017) Use of thiazolidinediones and risk of hip fracture in old people in a case–control study in Taiwan. Medicine 96:e7712

    Article  CAS  PubMed  Google Scholar 

  40. Liao KF, Lin CL, Lai SW (2017) Population-based case–control study assessing the association between statins use and pulmonary tuberculosis in Taiwan. Front Pharmacol 8:597

    Article  PubMed  PubMed Central  Google Scholar 

  41. Adams AL, Black MH, Zhang JL, Shi JM, Jacobsen SJ (2014) Proton-pump inhibitor use and hip fractures in men: a population-based case–control study. Ann Epidemiol 24:286–290

    Article  PubMed  Google Scholar 

  42. Abrahamsen B, Vestergaard P (2013) Proton pump inhibitor use and fracture risk—effect modification by histamine H1 receptor blockade. Observational case–control study using National Prescription Data. Bone 57:269–271

    Article  CAS  PubMed  Google Scholar 

  43. Lenihan CR, Sukumaran Nair S, Vangala C, Ramanathan V, Montez-Rath ME, Winkelmayer WC (2017) Proton pump inhibitor use and risk of hip fracture in kidney transplant recipients. Am J Kidney Dis 69:595–601

    Article  CAS  PubMed  Google Scholar 

  44. Bodmer M, Meier C, Kraenzlin ME, Meier CR (2010) Proton pump inhibitors and fracture risk: true effect or residual confounding? Drug Saf 33:843–852

    Article  CAS  PubMed  Google Scholar 

  45. Freedberg DE, Kim LS, Yang YX (2017) The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice From the American Gastroenterological Association. Gastroenterology 152:706–715

    Article  CAS  PubMed  Google Scholar 

  46. Hsing AW, Ioannidis JP (2015) Nationwide population science: lessons from the Taiwan National Health Insurance Research Database. JAMA Intern Med. 175:1527–1529

    Article  PubMed  Google Scholar 

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Acknowledgement

This study was supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. College of Medicine, China Medical University, Taichung, Taiwan

    Shih-Wei Lai, Chih-Hsueh Lin & Cheng-Li Lin

  2. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan

    Shih-Wei Lai & Chih-Hsueh Lin

  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

  4. College of Medicine, Tzu Chi University, Hualien, Taiwan

    Kuan-Fu Liao

  5. Department of Internal Medicine, Taichung Tzu Chi General Hospital, No.66, Sec. 1, Fongsing Road, Tanzi District, Taichung City, 427, Taiwan

    Kuan-Fu Liao

Authors
  1. Shih-Wei Lai
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Contributions

Shih-Wei Lai contributed to the conception of the article, initiated the draft of the article, and revised the article. Chih-Hsueh Lin and Cheng-Li Lin conducted the data analysis and revised the article. Kuan-Fu Liao participated in the data interpretation and revised the article.

Corresponding author

Correspondence to Kuan-Fu Liao.

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Conflict of interest

The authors disclose no conflicts of interest.

Ethical approval

The study was approved by the Research Ethics Committee of China Medical University and Hospital in Taiwan (CMUH-104-REC2-115).

Informed consent

Insurance reimbursement claims data used in this study were available for public access. Patient identification numbers had been scrambled to ensure confidentiality. Patient informed consent was not required.

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Lai, SW., Lin, CH., Lin, CL. et al. Proton pump inhibitors therapy and the risk of hip fracture in older people in Taiwan. Eur Geriatr Med 9, 169–174 (2018). https://doi.org/10.1007/s41999-017-0022-2

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  • DOI: https://doi.org/10.1007/s41999-017-0022-2

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