title: Uses of proton pump inhibitors and hypomagnesemia.
abstract: OBJECTIVE
  Hypomagnesemia associated with proton pump inhibitor (PPI) therapy has been documented in case reports. We performed a cross-sectional study to examine the association between PPI use and serum magnesium (Mg) levels or hypomagnesemia.
  
  
  METHODS
  Data were extracted from hospitalized adults with basic metabolic panels and/or serum magnesium levels available during the hospital stays. The first Mg value was used for data analysis. Hypomagnesemia is defined as levels less than 1.7 mg/dL (or 0.70 mmol/L). Multiple linear and logistic regression analyses were used to assess the association between PPI use and Mg levels or hypomagnesemia, respectively.
  
  
  RESULTS
  Among study patients, PPI users (n = 207) had a mean Mg level of 1.91[SD = 0.34] mg/dL, and non-users (n = 280) 2.00 (0.30) mg/dL, p = 0.004. PPI use was associated with lower serum Mg levels (adjusted coefficient β = -0.10, 95% CI = [-0.16, -0.04]) after adjusting for confounders. PPI use was associated with risk of hypomagnesemia after adjusting for confounders (adjusted OR = 2.50, 95% CI = [1.43, 4.36]). Both standard (1) and high (2 or higher) defined daily dose units of PPI therapy were associated with hypomagnesemia.
  
  
  CONCLUSIONS
  PPI use was associated with lower serum Mg levels and hypomagnesemia in a population of hospitalized adult patients. Our study supports the general notion that long-term PPI use could be associated with sub-clinical Mg insufficiency or deficiency status.
authors.affiliation: Department of Geriatric Medicine/Gerontology, Ohio University Heritage College of Osteopathic Medicine (OU-HCOM), Athens, OH 45701, USA. gau@ohio.edu
authors.forename: Jen-Tzer
authors.initials: JT
authors.lastname: Gau
authors.forename: Yu-Xiao
authors.initials: YX
authors.lastname: Yang
authors.forename: Roger
authors.initials: R
authors.lastname: Chen
authors.forename: Tzu-Cheg
authors.initials: TC
authors.lastname: Kao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D054328:Proton Pump Inhibitors; D008274:Magnesium