PMID- 31671930
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20210624
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Print)
IS  - 1226-3303 (Linking)
VI  - 35
IP  - 5
DP  - 2020 Sep
TI  - Proton pump inhibitor use is associated with hip fracture development: a 
      nationwide population-based cohort study.
PG  - 1084-1093
LID - 10.3904/kjim.2018.331 [doi]
AB  - BACKGROUND/AIMS: Effect of proton pump inhibitor (PPI) use on the risk of hip 
      fracture is controversial. This study aimed to clarify the association between 
      PPI use and hip fracture risk using a large cohort. METHODS: This study recruited 
      participants from the nationwide cohort (n = 1,025,340). After exclusion of 
      participants who had hip fractures or were aged less than 40 years during the 
      baseline period (2002 to 2004), 371,806 participants were followed to 2013. 
      Participants prescribed PPIs for more than 90 days during baseline period were 
      defined as users. Fracture cases were defined when participants were hospitalized 
      with claims of a hip fracture. RESULTS: During 4,159,343 person-years of 
      follow-up, fractures developed more often in PPI users than in nonusers (relative 
      risk [RR], 1.787; 95% confidence interval [CI], 1.260 to 2.534; p = 0.002). The 
      results persisted after adjusting for age, sex, and many drugs relevant to 
      osteoporosis or influential in bone health. Furthermore, fracture risk associated 
      with PPI use increased with duration of use (p trend < 0.001). The fully adjusted 
      RRs of hip fracture development were 1.350 (95% CI, 1.203 to 1.515) for 1- to 
      90-day users, 1.487 (95% CI, 0.957 to 2.311) for 91- to 180-day users, and 1.771 
      (95% CI, 0.931 to 3.368) for > 180-day users. The positive association between 
      PPI use and fracture was also confirmed in a subgroup with health screening data 
      where further adjustment for body mass index, smoking status, alcohol 
      consumption, and physical activity was available (adjusted RR, 2.025; 95% CI, 
      1.151 to 3.564, p = 0.014). CONCLUSION: PPI use is associated with hip fracture 
      development.
FAU - Min, Yang Won
AU  - Min YW
AD  - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Korea.
FAU - Lee, Yeong Chan
AU  - Lee YC
AD  - Department of Digital Health, Samsung Advanced Institute for Health Science and 
      Technology, Sungkyunkwan University, Seoul, Korea.
FAU - Kim, Kyunga
AU  - Kim K
AD  - Department of Digital Health, Samsung Advanced Institute for Health Science and 
      Technology, Sungkyunkwan University, Seoul, Korea.
AD  - Statistics and Data Center, Research Institute for Future Medicine, Samsung 
      Medical Center, Seoul, Korea.
FAU - Ryu, Seungho
AU  - Ryu S
AD  - Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, 
      Sungkyunkwan University, Seoul, Korea.
AD  - Department of Clinical Research Design and Evaluation, Samsung Advanced Institute 
      for Health Science and Technology, Sungkyunkwan University School of Medicine, 
      Seoul, Korea.
AD  - Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, 
      Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Hong, Kyoung Sub
AU  - Hong KS
AD  - Department of Gastroenterology, Mediplex Sejong Hospital, Incheon, Korea.
FAU - Jeon, Han Ho
AU  - Jeon HH
AD  - Division of Gastroenterology, Department of Internal Medicine, National Health 
      Insurance Service Ilsan Hospital, Ilsan, Korea.
FAU - Kim, Yong Sung
AU  - Kim YS
AD  - Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, 
      Wonkwang University Sanbon Hospital, Gunpo, Korea.
FAU - Park, Jong Heon
AU  - Park JH
AD  - Big Data Steering Department, National Health Insurance Service, Wonju, Korea.
FAU - Son, Hee Jung
AU  - Son HJ
AD  - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Korea.
FAU - Rhee, Poong-Lyul
AU  - Rhee PL
AD  - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of 
      Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
DEP - 20191104
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Cohort Studies
MH  - *Hip Fractures/chemically induced/diagnosis/epidemiology
MH  - Humans
MH  - *Osteoporosis
MH  - Proton Pump Inhibitors/adverse effects
MH  - Risk
MH  - Risk Factors
PMC - PMC7487306
OTO - NOTNLM
OT  - Drug side effect
OT  - Hip fracture
OT  - Proton pump inhibitor
COIS- No potential conflicts of interest relevant to this article are reported.
EDAT- 2019/11/02 06:00
MHDA- 2021/06/25 06:00
PMCR- 2020/09/01
CRDT- 2019/11/02 06:00
PHST- 2018/09/10 00:00 [received]
PHST- 2018/11/13 00:00 [accepted]
PHST- 2019/11/02 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
PHST- 2019/11/02 06:00 [entrez]
PHST- 2020/09/01 00:00 [pmc-release]
AID - kjim.2018.331 [pii]
AID - kjim-2018-331 [pii]
AID - 10.3904/kjim.2018.331 [doi]
PST - ppublish
SO  - Korean J Intern Med. 2020 Sep;35(5):1084-1093. doi: 10.3904/kjim.2018.331. Epub 
      2019 Nov 4.