Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.
Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.
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绝经后妇女的质子泵抑制剂使用，髋部骨折和骨矿物质密度的变化：女性健康计划的结果。
DOI：
10.1001/archinternmed.2010.94
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发表时间：
2010-05-10
影响因子：
--
通讯作者：
Chen, Zhao
中科院分区：
文献类型：
--
作者：
Gray, Shelly L.;LaCroix, Andrea Z.;Larson, Joseph;Robbins, John;Cauley, Jane A.;Manson, JoAnn E.;Chen, Zhao
质子泵抑制剂（PPI）药物与骨质疏松性骨折的相关性不一致。目的是检查PPI使用与骨结局（骨折，骨矿物质密度[BMD]）的相关性。该前瞻性分析包括161，806名年龄在50至79岁之间的绝经后妇女，这些妇女没有髋部骨折史，参加了妇女健康倡议（WHI）观察性研究和临床试验，平均（SD）随访7.8（1.6）年。对130 487名信息完整的妇女进行了分析。在面对面访谈期间（基线，第3年），直接从药物容器中获取药物信息。主要结局指标是自我报告的骨折（髋关节[裁定]、临床脊柱、下臂或腕关节和总骨折），以及子样本（3个密度测定部位）的3年BMD变化。在1，005，126人年的随访中，发生了1500例髋部骨折，4881例下臂或腕部骨折，2315例临床脊柱骨折和21247例骨折。当前PPI使用的多变量校正风险比为：髋部骨折1.00（95% CI，0.71 - 1.40），临床脊柱骨折1.47（CI 1.18-1.82），下臂或腕部骨折1.26（CI，1.05 - 1.51），全骨折1.25（CI，1.15 - 1.36）。在基线时，PPI使用者和非使用者的BMD测量值没有变化。PPI的使用仅与髋关节（p=0.05）的3年BMD变化的边际效应相关，而与其他部位无关。PPI的使用与髋部骨折无关，但与临床脊柱、下臂或腕关节和全骨折中度相关。
Proton pump inhibitor (PPI) medications have been inconsistently shown to be associated with osteoporotic fractures. The objective was to examine the association of PPI use with bone outcomes (fracture, bone mineral density [BMD]) This prospective analysis included 161,806 postmenopausal women ages 50 to 79 years 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 on 130,487 women with complete information. Medication information was taken directly from drug containers during in-person interviews (baseline, year 3). Main outcome measures were self-reported fractures (hip [adjudicated], clinical spine, lower arm or wrist, and total fractures) and for a subsample (3 densitometry sites), 3-year change in BMD. During 1,005,126 person-years of follow-up, 1500 hip fractures, 4881 lower arm or wrist fractures, 2315 clinical spine fractures and 21247 total fractures occurred. The multivariate-adjusted hazard ratios for current PPI use were 1.00 (95% CI, 0.71 to 1.40) for hip fracture, 1.47 (CI 1.18–1.82) for clinical spine fracture, 1.26 (CI, 1.05 to 1.51) for lower arm or wrist fracture, and 1.25 (CI, 1.15 to 1.36) for total fractures. BMD measurements did not vary between PPI users and nonusers at baseline. PPI use was associated with only a marginal effect on 3-year BMD change at the hip (p=0.05) but not at other sites. PPI use was not associated with hip fractures, but was modestly associated with clinical spine, lower arm or wrist and total fractures.
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影响因子：
4.2
作者：
Yu, Elaine W.;Blackwell, Terri;Ensrud, Kristine E.;Hillier, Teresa A.;Lane, Nancy E.;Orwoll, Eric;Bauer, Douglas C.
通讯作者：
Bauer, Douglas C.
影响因子：
14.6
作者：
Targownik, Laura E.;Lix, Lisa M.;Leslie, William D.
通讯作者：
Leslie, William D.
影响因子：
2.5
作者：
Graziani, G;Badalamenti, S;Ponticelli, C
通讯作者：
Ponticelli, C
影响因子：
5
作者：
Kristal, AR;Feng, ZD;George, V
通讯作者：
George, V
影响因子：
4.1
作者：
Kaye, James A.;Jick, Hershel
通讯作者：
Jick, Hershel