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Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: Results from the women's health initiative

Gray, SL and Lacroix, AZ and Larson, J and Robbins, J and Cauley, JA and Manson, JE and Chen, Z (2010) Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: Results from the women's health initiative. Archives of Internal Medicine, 170 (9). 765 - 771. ISSN 0003-9926

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Background: Proton pump inhibitor (PPI) medications have been inconsistently shown to be associated with osteoporotic fractures. We examined the association of PPI usewith bone outcomes (fracture, bone mineral density [BMD]). Methods: This prospective analysis included 161 806 postmenopausal women 50 to 79 years old, without history of hip fracture, enrolled in the Women's Health Initiative (WHI) Observational Study and Clinical Trials with a mean (SD) follow-up of 7.8 (1.6) years. Analyses were conducted for 130 487 women with complete information. Medication information was taken directly from drug containers during in-person interviews (baseline, year 3). The main outcome measures were self-reported fractures (hip [adjudicated], clinical spine, forearm or wrist, and total fractures) and for a subsample (3 densitometry sites), 3-year change in BMD. Results: During 1 005 126 person-years of follow-up, 1500 hip fractures, 4881 forearm or wrist fractures, 2315 clinical spine fractures, and 21 247 total fractures occurred. The multivariate-adjusted hazard ratios for current PPI use were 1.00 (95% confidence interval [CI], 0.71-1.40) for hip fracture, 1.47 (95% CI, 1.18-1.82) for clinical spine fracture, 1.26 (95% CI, 1.05-1.51) for forearm or wrist fracture, and 1.25 (95% CI, 1.15-1.36) for total fractures. The BMD measurements did not vary between PPI users and nonusers at baseline. Use of PPIs was associated with only a marginal effect on 3-year BMD change at the hip (P=.05) but not at other sites. Conclusion: Use of PPIs was not associated with hip fractures but wasmodestly associated with clinical spine, forearm or wrist, and total fractures. ©2010 American Medical Association. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Gray, SL
Lacroix, AZ
Larson, J
Robbins, J
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Manson, JE
Chen, Z
Date: 10 May 2010
Date Type: Publication
Journal or Publication Title: Archives of Internal Medicine
Volume: 170
Number: 9
Page Range: 765 - 771
DOI or Unique Handle: 10.1001/archinternmed.2010.94
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0003-9926
Date Deposited: 24 Nov 2015 18:30
Last Modified: 02 Feb 2019 15:55


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