Yang Yu-Xiao
Division of Gastroenterology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104-6021, USA.
Curr Gastroenterol Rep. 2012 Dec;14(6):473-9. doi: 10.1007/s11894-012-0290-4.
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.
自20世纪80年代末质子泵抑制剂（PPI）问世以来，因其对酸相关病症疗效显著，已被广泛应用。然而，近期一些流行病学研究表明，PPI治疗与骨质疏松性骨折风险之间存在正相关。这种关联背后的潜在机制可能与长期抑酸对钙代谢的生理影响有关。首先，PPI治疗引起的慢性高胃泌素血症可能导致甲状旁腺增生，从而增加骨钙流失。其次，深度胃酸抑制可能会降低钙在肠道吸收的生物利用度。我将回顾关于这些潜在联系的已发表证据，并讨论其临床意义。
