Qorraj-Bytyqi Hasime, Hoxha Rexhep, Sadiku Shemsedin, Bajraktari Ismet H, Sopjani Mentor, Thaçi Kujtim, Thaçi Shpetim, Bahtiri Elton
Department of Pharmacology, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo.
Clinic of Hematology, University Clinical Center of Kosovo, Prishtina, Kosovo.
Open Access Maced J Med Sci. 2018 Mar 12;6(3):442-446. doi: 10.3889/oamjms.2018.142. eCollection 2018 Mar 15.
Proton pump inhibitors (PPIs) represent the most widely prescribed antisecretory agents, but their prolonged use, may influence iron and vitamin B12 status, which could have important implications for clinical practice.
We undertook this study aiming to investigate the association between PPIs use for 12 months and potential changes in iron and vitamin B12 status, as well as whether this potential association varies among four specific PPI drugs used in the study.
A total of 250 adult subjects were recruited into this study, of which 200 subjects were PPIs users while 50 subjects belonged to the control group. Serum iron, ferritin, vitamin B12, and homocysteine (Hcy) levels were measured before the start of the study and after 12 months. Mann - Whitney U test and Kruskal - Wallis test was used to compare the baseline characteristics of the study groups, while Wilcoxon test was used to analyse post - pre differences.
Statistical analysis showed significant changes within PPIs group and specific PPIs subgroups between the two-time points in serum ferritin and vitamin B12 levels, respectively, while no significant changes in serum iron and homocysteine levels were shown. However, subsequent diagnosis of hypoferremia and hypovitaminosis B12 in the whole study sample at 12 months was established in only 3.8% and 2.9% of the subjects, respectively.
PPIs use for 12 months did not result in clinically significant iron and/or vitamin B12 deficiency; thus, these findings argue routine screening under normal circumstances, although monitoring in elderly and malnourished may be of precious value.
质子泵抑制剂（PPIs）是使用最广泛的抗分泌药物，但其长期使用可能会影响铁和维生素B12的状态，这可能对临床实践具有重要意义。
我们开展这项研究旨在调查使用质子泵抑制剂12个月与铁和维生素B12状态的潜在变化之间的关联，以及这种潜在关联在本研究中使用的四种特定质子泵抑制剂药物之间是否存在差异。
本研究共招募了250名成年受试者，其中200名受试者使用质子泵抑制剂，50名受试者属于对照组。在研究开始前和12个月后测量血清铁、铁蛋白、维生素B12和同型半胱氨酸（Hcy）水平。使用曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验比较研究组的基线特征，而使用威尔科克森检验分析前后差异。
统计分析显示，质子泵抑制剂组和特定质子泵抑制剂亚组在两个时间点之间血清铁蛋白和维生素B12水平分别有显著变化，而血清铁和同型半胱氨酸水平无显著变化。然而，在12个月时整个研究样本中低铁血症和维生素B12缺乏症的后续诊断分别仅在3.8%和2.9%的受试者中得到证实。
使用质子泵抑制剂12个月并未导致临床上显著的铁和/或维生素B12缺乏；因此，这些发现表明在正常情况下无需进行常规筛查，尽管对老年人和营养不良者进行监测可能具有重要价值。
