title: The relationship between proton pump inhibitor use and longitudinal change in bone mineral density: a population-based study [corrected] from the Canadian Multicentre Osteoporosis Study (CaMos).
abstract: OBJECTIVE
  Proton pump inhibitor (PPI) use has been identified as a risk factor for hip and vertebral fractures. Evidence supporting a relationship between PPI use and osteoporosis remains scant. Demonstrating that PPIs are associated with accelerated bone mineral density (BMD) loss would provide supportive evidence for a mechanism through which PPIs could increase fracture risk.
  
  
  METHODS
  We used the Canadian Multicentre Osteoporosis Study data set, which enrolled a population-based sample of Canadians who underwent BMD testing of the femoral neck, total hip, and lumbar spine (L1-L4) at baseline, and then again at 5 and 10 years. Participants also reported drug use and exposure to risk factors for osteoporosis and fracture. Multivariate linear regression was used to determine the independent association of PPI exposure and baseline BMD, and on change in BMD at 5 and 10 years.
  
  
  RESULTS
  In all, 8,340 subjects were included in the baseline analysis, with 4,512 (55%) undergoing year 10 BMD testing. After adjusting for potential confounders, PPI use was associated with significantly lower baseline BMD at the femoral neck and total hip. PPI use was not associated with a significant acceleration in covariate-adjusted BMD loss at any measurement site after 5 and 10 years of follow-up.
  
  
  CONCLUSIONS
  PPI users had lower BMD at baseline than PPI non-users, but PPI use over 10 years did not appear to be associated with accelerated BMD loss. The reasons for discordant findings between PPI use at baseline and during follow-up require further study.
authors: University of Manitoba, Winnipeg, Manitoba, Canada. targowni@cc.umanitoba.ca
authors: Laura E
authors: LE
authors: Targownik
authors: William D
authors: WD
authors: Leslie
authors: K Shawn
authors: KS
authors: Davison
authors: David
authors: D
authors: Goltzman
authors: Sophie A
authors: SA
authors: Jamal
authors: Nancy
authors: N
authors: Kreiger
authors: Robert G
authors: RG
authors: Josse
authors: Stephanie M
authors: SM
authors: Kaiser
authors: Christopher S
authors: CS
authors: Kovacs
authors: Jerilynn C
authors: JC
authors: Prior
authors: Wei
authors: W
authors: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects*; D002170:Canada; D005260:Female; D005272:Femur Neck / Q000187:drug effects*; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced*; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012307:Risk Factors; D016103:Spinal Fractures / Q000209:etiology; D013131:Spine / Q000187:drug effects*
chemical_list: D054328:Proton Pump Inhibitors