title: Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women. The WHILA study.
abstract: Postmenopausal women in the Western world are highly burdened by osteoporotic fractures. The aim of this study is to investigate risk factors at baseline for fracture in 6416 postmenopausal women during long-term follow-up. At baseline, all women completed a questionnaire regarding background factors, diseases, current use of medications and reproductive and contraceptive history, a physical examination and laboratory analyses. Fracture occurrence after inclusion in the study was recorded with the help of official registries. All significant variables in univariate logistic regression with a decreased or increased risk for fracture were analysed in a multivariate logistic regression. Increased fracture risk was observed in women currently using proton pump inhibitors (PPI), odds ratio (OR) 2.53 (95% confidence interval (CI)) 1.28-4.99, and women having had a fracture after the age of 40, but before inclusion in the study, OR 1.70 (95% CI 1.24-2.32). A protective effect against fractures was observed in women with a positive family history of diabetes OR 0.66 (95% CI 0.44-0.98). A significant interaction was observed between fracture risk, use of PPI and HT status (p=0.014) and women with HT had an increased fracture risk with use of PPI (OR 3.37 (95% CI 1.96-5.80)) compared to women without HT (OR 1.13 (95% CI 0.57-2.24)). In conclusion, usage of PPIs was associated with a doubled risk for fracture in postmenopausal women. Women with previous fractures using PPI should be considered for prophylactic treatment reducing fracture risk.
authors: Clinical Sciences, Department of Obstetrics and Gynaecology, Skåne University Hospital, Lund University, SE-221 85 Lund, Sweden. Electronic address: louise.moberg@med.lu.se.
authors: Louise M E
authors: LM
authors: Moberg
authors: Clinical Sciences, Department of Obstetrics and Gynaecology, Skåne University Hospital, Lund University, SE-221 85 Lund, Sweden. Electronic address: peter.nilsson@med.lu.se.
authors: Peter M
authors: PM
authors: Nilsson
authors: Clinical Sciences, Department of Obstetrics and Gynaecology, Skåne University Hospital, Lund University, SE-221 85 Lund, Sweden. Electronic address: goran.samsioe@hotmail.com.
authors: Göran
authors: G
authors: Samsioe
authors: Clinical Sciences, Department of Obstetrics and Gynaecology, Skåne University Hospital, Lund University, SE-221 85 Lund, Sweden. Electronic address: christer.borgfeldt@med.lu.se.
authors: Christer
authors: C
authors: Borgfeldt
mesh_terms: D015519:Bone Density; D003920:Diabetes Mellitus; D015914:Estrogen Replacement Therapy; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D058866:Osteoporotic Fractures / Q000209:etiology*; D017698:Postmenopause; D065840:Protective Factors; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D054328:Proton Pump Inhibitors
keywords: Bone mineral density (BMD); Fracture risk; Postmenopausal women; Previous fracture; Proton pump inhibitors (PPI)