Chronic proton pump inihibitor therapy and calcium metabolism.
Proton pump inhibitors (PPIs) have been widely used since their introduction in the late 1980s because they are highly effective for acid-related conditions. However, some recent epidemiological studies have suggested a positive association between PPI therapy and the risk of osteoporotic fractures. The potential mechanisms underlying this association may be related to the physiologic effects of chronic acid suppression on calcium metabolism. First, chronic hypergastrinemia induced by PPI therapy may lead to parathyroid hyperplasia, resulting in increased loss of calcium from the bone. Second, profound gastric acid suppression may reduce the bioavailability of calcium for intestinal absorption. I will review the published evidence regarding these potential links and discuss their clinical implications.
Division of Gastroenterology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104-6021, USA. yangy@mail.med.upenn.edu
Yu-Xiao
YX
Yang
D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D006801:Humans; D006961:Hyperparathyroidism / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D010280:Parathyroid Glands / Q000378:metabolism*; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000494:pharmacology
D054328:Proton Pump Inhibitors; D002118:Calcium