PMID- 23973557
OWN - NLM
STAT- MEDLINE
DCOM- 20140417
LR  - 20220321
IS  - 1873-2763 (Electronic)
IS  - 1873-2763 (Linking)
VI  - 57
IP  - 1
DP  - 2013 Nov
TI  - Proton pump inhibitor use and fracture risk - effect modification by histamine H1 
      receptor blockade. Observational case-control study using National Prescription 
      Data.
PG  - 269-71
LID - S8756-3282(13)00328-1 [pii]
LID - 10.1016/j.bone.2013.08.013 [doi]
AB  - It remains unknown why proton pump inhibitor (PPI) use may be associated with 
      risk of osteoporotic fractures; evidence of direct effects on calcium absorption 
      or on the osteoclast in humans is weak or absent. However, the ensuing increased 
      gastrin levels may cause histamine production through hypertrophy of gastric 
      enterochromaffin like cells, which could lead to bone loss. We speculated that H1 
      receptor antagonists (H1RA) used for allergies would then reduce the effect of 
      PPI on bone. We therefore conducted a register-based case-control study 
      comprising 124,655 patients with hospital treated fractures, who were matched 3:1 
      with non fracture control subjects of the same age and gender. Use of 
      prescription medications was retrieved from the National Prescription Database 
      and data was analyzed using conditional logistic regression analysis. We observed 
      a significant interaction between PPI and H1RA use on fracture risk in general 
      (adjusted OR 0.92, 95% CI 0.87-0.98) though not on hip fracture risk (adjusted OR 
      0.99, 95% CI 0.85-1.16). There was a significant modification of the interaction 
      by age (p<0.05 for both fracture categories). As previously shown, fracture risk 
      was higher in PPI users both for fractures in general and for hip fractures. 
      Irrespective of PPI use, H1RA users had lower risk of hip fractures than 
      non-users (adjusted OR 0.86, 95% CI 0.79-0.93). This short report suggests that 
      the effects of PPI on bone could be driven by in part by increased histamine 
      release as the increased fracture risk can be modified by H1RA.
CI  - (c) 2013.
FAU - Abrahamsen, Bo
AU  - Abrahamsen B
AD  - Department of Medicine F, Gentofte Hospital, Copenhagen, Denmark; OPEN, Institute 
      of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic 
      address: b.abrahamsen@physician.dk.
FAU - Vestergaard, Peter
AU  - Vestergaard P
LA  - eng
PT  - Journal Article
DEP - 20130822
PL  - United States
TA  - Bone
JT  - Bone
JID - 8504048
RN  - 0 (Histamine Antagonists)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Receptors, Histamine H1)
RN  - 820484N8I3 (Histamine)
SB  - IM
MH  - Aged
MH  - Case-Control Studies
MH  - Female
MH  - Fractures, Bone/*epidemiology/*etiology
MH  - Histamine/*metabolism
MH  - Histamine Antagonists/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Receptors, Histamine H1/*metabolism
MH  - Risk Factors
OTO - NOTNLM
OT  - Antihistamines
OT  - Epidemiology
OT  - Fractures
OT  - Histamine
OT  - Osteoporosis
OT  - Proton-pump inhibitors
EDAT- 2013/08/27 06:00
MHDA- 2014/04/18 06:00
CRDT- 2013/08/27 06:00
PHST- 2013/06/12 00:00 [received]
PHST- 2013/07/14 00:00 [revised]
PHST- 2013/08/15 00:00 [accepted]
PHST- 2013/08/27 06:00 [entrez]
PHST- 2013/08/27 06:00 [pubmed]
PHST- 2014/04/18 06:00 [medline]
AID - S8756-3282(13)00328-1 [pii]
AID - 10.1016/j.bone.2013.08.013 [doi]
PST - ppublish
SO  - Bone. 2013 Nov;57(1):269-71. doi: 10.1016/j.bone.2013.08.013. Epub 2013 Aug 22.