Chronic proton pump inihibitor therapy and calcium metabolism.
Chronic proton pump inihibitor therapy and calcium metabolism.
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DOI：
10.1007/s11894-012-0290-4
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发表时间：
2012-12-01
影响因子：
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通讯作者：
Yang, Yu-Xiao
中科院分区：
文献类型：
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作者：
Yang, Yu-Xiao
质子泵抑制剂(PPI)自20世纪80年代末问世以来得到了广泛的应用，因为它们对酸相关的条件非常有效。然而，最近的一些流行病学研究表明，PPI治疗与骨质疏松性骨折的风险呈正相关。这种联系的潜在机制可能与慢性酸抑制对钙代谢的生理影响有关。首先，PPI治疗引起的慢性胃泌素血症可能会导致甲状旁腺增生，导致骨骼钙流失增加。其次，严重的胃酸抑制可能会降低钙在肠道吸收的生物利用率。我将回顾已发表的关于这些潜在联系的证据，并讨论它们的临床意义。
Proton pump inhibitors (PPIs) have been widely used since their introduction in the late 1980s because they are highly effective for acid-related conditions. However, some recent epidemiological studies have suggested a positive association between PPI therapy and the risk of osteoporotic fractures. The potential mechanisms underlying this association may be related to the physiologic effects of chronic acid suppression on calcium metabolism. First, chronic hypergastrinemia induced by PPI therapy may lead to parathyroid hyperplasia, resulting in increased loss of calcium from the bone. Second, profound gastric acid suppression may reduce the bioavailability of calcium for intestinal absorption. I will review the published evidence regarding these potential links and discuss their clinical implications.