Acid-suppressive medications and risk of bone loss and fracture in older adults

Elaine W. Yu, Terri Blackwell, Kristine E. Ensrud, Teresa A. Hillier, Nancy E. Lane, Eric Orwoll, Douglas C. Bauer

Research output: Contribution to journalArticle

162 Scopus citations

Abstract

Recent studies have suggested an increased fracture risk with acid-suppressive medication use. We studied two cohorts of men and women over age 65 who were enrolled in the Osteoporotic Fractures in Men Study (MrOS) and the Study of Osteoporotic Fractures (SOF), respectively. We used dual-energy X-ray absorptiometry and assessed baseline use of proton pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs) in 5,755 men and 5,339 women. Medication use and bone mineral density (BMD) were assessed, and hip and other nonspine fractures were documented. On multivariate analysis, men using either PPIs or H2RAs had lower cross-sectional bone mass. No significant BMD differences were observed among women. However, there was an increased risk of nonspine fracture among women using PPIs (relative hazard [RH] = 1.34, 95% confidence interval [CI] 1.10-1.64). PPI use was also associated with an increased risk of nonspine fracture in men but only among those who were not taking calcium supplements (RH = 1.49, 95% CI 1.04-2.14). H2RA use was not associated with nonspine fractures, and neither H2RA use nor PPI use was associated with incident hip fractures in men or women. The use of PPIs in older women, and perhaps older men with low calcium intake, may be associated with a modestly increased risk of nonspine fracture.

Original languageEnglish (US)
Pages (from-to)251-259
Number of pages9
JournalCalcified Tissue International
Volume83
Issue number4
DOIs
StatePublished - Oct 2008

Keywords

  • Bone density
  • Fracture
  • H2 receptor antagonist
  • Proton pump inhibitor

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology

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    Yu, E. W., Blackwell, T., Ensrud, K. E., Hillier, T. A., Lane, N. E., Orwoll, E., & Bauer, D. C. (2008). Acid-suppressive medications and risk of bone loss and fracture in older adults. Calcified Tissue International, 83(4), 251-259. https://doi.org/10.1007/s00223-008-9170-1