title: Use of proton pump inhibitors and risk of fragility hip fracture in a Mediterranean region.
abstract: OBJECTIVE
  To determine whether there is an increased risk of hip fracture associated with the use of proton pump inhibitors in a Mediterranean area after adjusting for other potential risk factors.
  
  
  METHODS
  Retrospective multicenter case-control study carried out in 6 primary health care centers in Catalonia, Spain. Cases were patients aged 50years and over with a fragility hip fracture registered between January 2007 and December 2010, matched with 2 controls by sex and age.
  
  
  METHODS
  use of proton pump inhibitors (type, dosage) in the 5years previous to the hip fracture, socio-demographic data, body mass index, alcohol and tobacco consumption as well as health conditions and drugs associated with an increase risk of fragility hip fracture.
  
  
  RESULTS
  358 cases were matched with 698 controls. The mean age was 82years old in both groups. Women represented 77.1% in the case group and 76.9% in the control group. Crude association between proton pump inhibitors and hip fracture was 1.44 (95% CI, 1.09-1.89) and adjusted OR was 1.24 (95% CI, 0.93-1.65). No association was found with the continuous or discontinuous use of proton pump inhibitors, OR 1.17 (95% CI, 0.77-1.79), and OR of 1.16 (95% CI, 0.85-1.60) respectively. No association was found when restricting the analysis by sex, OR of 1.19 (95% CI, 0.27-5.14) or by age, younger or older than 80years, OR of 0.72 (95% CI, 0.24-2.15).
  
  
  CONCLUSIONS
  The use of proton pump inhibitors was not associated with an increased risk of hip fracture after adjusting for other risk factors in a Mediterranean area. This result suggests the existence of protective environmental factors linked to this southern area of Europe that eventually could compensate for the potential harm produced by proton pump inhibitors.
authors.affiliation: Primary Health Care Center Eap Sardenya, c/ Sardenya 466, 08025, Barcelona, Spain. creyes@eapsardenya.cat
authors.forename: Carlen
authors.initials: C
authors.lastname: Reyes
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.forename: Marta
authors.initials: M
authors.lastname: Coderch
authors.forename: Jordi
authors.initials: J
authors.lastname: Hoyo
authors.forename: Gemma
authors.initials: G
authors.lastname: Ferriz
authors.forename: Jordi
authors.initials: J
authors.lastname: Casanovas
authors.forename: Rosa
authors.initials: R
authors.lastname: Monteserín
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons
authors.forename: Marta
authors.initials: M
authors.lastname: Rojas
authors.forename: Irene
authors.initials: I
authors.lastname: Moral
mesh_terms: D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006262:Health; D006620:Hip Fractures / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D054328:Proton Pump Inhibitors