Effect of long-term proton pump inhibitors on phosphocalcium metabolism and bone mineral density

Figures & data

Table 1. Characteristics of PPI usage in the study population.

Proton pump inhibitor		Percentage (%)
Therapeutic class	Oméprazole	81.1%
	Esoméprazole	18.9%
Dose	Single	93.3%
	Double	6.7%
Frequency of administration	Daily	78.9%
	Every 2 days	7.8%
	Every 3 days	8.9%
	Every 7 days	4.4%
Consistency of administration	Regular	64.4%
	Irregular	35.6%
Timing of administration	Before meals	44.4%
	After meals	55.6%
Combination with antacid and/or mucoprotective agent	Yes	87.8%
	No	12.2%

Table 2. Comparison of clinical, biological, and osteodensitometric data in the study population.

Parameter		Patients (N = 90)	Controls (N = 90)	p-value
Epidemiological	Age mean (years)	54.77 ± 12.21	55.17 ± 12.4	0.83
	Gender (M/F)	40/50	37/53	0.56
	Tobacco (yes/no)	73/17	78/12	0.31
	Alcohol (yes/no)	87/3	87/3	1
	Menopause (no/yes)	25/25	21/32	0.29
	Veil-wearing (no/yes)	8/43	12/41	0.39
Clinical	Mean BMI (kg/m^2)	28.54 ± 4.01	28.05 ± 3.95	0.47
	Mean corrected calcium (mmol/l)	2.24 ± 0.16	2.27 ± 0.18	0.10
	Calcium (normal/high/low)	58/32/0	70/20/0	0.048^†
	Mean PH (mmol/l)	1.08 ± 0.18	1.00 ± 0.07	0.002^†
	Phosphoremia (normal/low)	84/6	80/10	0.29
	Mean magnesium (mmol/l)	0.82 ± 0.09	0.93 ± 0.12	0.0001^†
	Magnesium (normal/high/low)	81/9/0	88/2/0	0.029^†
	Mean PAL (UI/L)	79.56 ± 22.07	77.65 ± 23.1	0.65
	Mean vitamin D3 (ng/ml)	19.72 ± 10.79	14.77 ± 10.52	0.001^†
	Vitamin D3 (normal/low)	10/80	7/83	0.44
	Mean PTH (pg/ml)	66.48 ± 32.4	55.08 ± 31.8	0.005^†
	PTH (normal/ high)	50/40	67/23	0.008^†
	Mean hemoglobin (g/dl)	13.14 ± 1.15	12.69 ± 1.3	0.03^†
	Ferritinemia (μg/l)	68.02 ± 70.01	65.31 ± 85.3	0.79
	TSH (mU/l)	2.32 ± 0.93	1.92 ± 1.04	0.23
Osteodensitometry	Bone Mass (normal/osteopenia/osteoporosis)	38/46/6	59/23/1	0.0001^†
	Bone Mass (normal/low)	38/52	59/24	0.0001^†
	Mean Spine T-score (DS)	-0.61 ± 1.53	0.05 ± 1.13	0.003^†
	Mean Spine Z-score (DS)	-0.35 ± 1.37	0.13 ± 1.5	0.03^†
	Mean Femur T-score (DS)	-0.55 ± 0.17	-0.26 ± 0.25	0.09
	Mean Femur Z-score (DS)	0.05 ± 1.04	0.32 ± 1.17	0.11

† p-values that were considered statistically significant.

Table 3. Risk factors for osteopenia in the population treated with PPIs in univariate analysis.

DMO		Low	Normal	p-value
Epidémiological	Age (<50ans/ >50ans)	9/43	14/24	0.036^†
	Gender (M/F)	22/30	18/20	0.63
	Average solar index (h/week)	2.12	1.75	0.65
	Physical activity (sedentary/average)	42/10	24/14	0.062
	Menopause (no/yes)	11/19	14/6	0.021^†
	Veil wearing (no/yes)	1/29	7/13	0.005^†
Clinical	BMI (kg/m^2)	28,84	28,13	0.41
	PPIs class (omeprazole/esomeprazole)	45/7	28/10	0.12
	Regularity (regular/irregular)	39/19	19/19	0.014^†
	Daily dose (simple dose/double dose)	46/6	38/0	0.037^†
	Frequency (every day/ ≥1 day/2)	47/5	24/14	0.002^†
	Duration (mean)	94.85	99.13	0.74
	Schedule (before meal/ after meal)	18/34	22/16	0.028^†
	Combination with an antacid (no/yes)	47/5	32/6	0.51
	Combination with a mucoprotective agent (no/yes)	50/2	29/9	0.007^†
Histological	Presence of HP (no/ yes)	2/26	1/18	0.67
	Calcuim (normale ou élevée/basse)	31/21	27/11	0.26
	Phosphoremia (normal/low)	51/1	33/5	0.08
	Magnesemia (normal/low)	46/6	35/3	0.73
	VitD3 (mean)	18.15	21.88	0.14
	Vit D3 (normal/low)	3/49	7/31	0.083
	PTH (mean)	65,41	67,93	0.71
	PTH (low or normal/high)	29/23	21/14	0.96

† p-values that were considered statistically significant.

Table 4. Risk factors for a decrease in bone mineral density in multivariate study.

Risk factor	p-value	OR
Age >50ans	0.032^†	2.78
Physical activity	0.114	–
Menopause	0.280	–
Veil wearing	0.128	–
PPIs class	0.114	–
Regularity	0.051	–
Daily dose	0.999	–
Frequency	0.404	–
schedule	0.754	–
Combination with a mucoprotective agent	0.056	–
Vitamine D3	0.838	–

† p-values that were considered statistically significant.