Institute of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Pharmacoepidemiol Drug Saf. 2010 Nov;19(11):1131-6. doi: 10.1002/pds.2026.
To investigate whether the use of proton pump inhibitor (PPIs) was associated with an increased risk of hip fracture.
We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National health Insurance Research Database. Cases included all patients with a newly diagnosed of hip fracture in 2005 and 2006 (n = 1241). The controls were pair matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by using multiple logistic regression.
Having been prescribed more than 28 defined daily dose (DDDs) of PPIs was associated with an increased risk for hip fracture in multivariate analyses (adjustments for matching variables and medication use) (at 29-70 DDDs, OR = 1.67, 95% CI = 1.11-2.51 and at >70 DDDs, OR = 2.51, 95% CI = 1.77-3.55). There was a significant trend toward increasing hip fracture risk with increasing cumulative DDDs of PPIs (p for trend <0.0001).
This study provides evidence that PPIs use is associated with an increased risk of hip fracture in a dose-response manner.
研究质子泵抑制剂（PPIs）的使用是否与髋部骨折风险增加相关。
我们在台湾进行了一项基于人群的病例对照研究。数据从 2005 年和 2006 年台湾全民健康保险研究数据库中回顾性收集。病例包括所有新诊断为髋部骨折的患者（n=1241）。对照组通过年龄、性别和索引日期与病例进行配对。使用多因素逻辑回归估计调整后的比值比（OR）和 95%置信区间（CI）。
多因素分析（调整匹配变量和药物使用）显示，处方超过 28 个定义日剂量（DDD）的 PPI 与髋部骨折风险增加相关（在 29-70 DDD 时，OR=1.67，95%CI=1.11-2.51；在 >70 DDD 时，OR=2.51，95%CI=1.77-3.55）。随着 PPI 累积 DDD 的增加，髋部骨折风险呈显著增加趋势（趋势检验 p<0.0001）。
本研究提供了证据表明，PPIs 的使用与髋部骨折风险呈剂量反应关系增加相关。
