Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
J Gastroenterol Hepatol. 2020 Jan;35(1):19-28. doi: 10.1111/jgh.14789. Epub 2019 Aug 29.
A growing body of literature suggests the association between dementia risk and proton pump inhibitor (PPI) use. Therefore, we aimed to investigate the association between PPI use and dementia risk.
An extensive literature search was performed in PubMed, Embase, and Cochrane till March 31, 2019. All the studies (cohort and case-control) assessing the association between PPI use and dementia risk were eligible for inclusion. Articles were selected based on the screening of title and abstract, data were extracted, and risk of bias was assessed using Newcastle-Ottawa scale. The primary outcome was pooled risk of dementia among PPI user as compared with non-PPI user. Secondary outcomes include dementia risk based on subgroups. Statistical analysis was performed using review manager software.
Twelve studies (eight cohort and four case-control) were found to be eligible for inclusion. Majority of the studies were of high quality. Dementia was diagnosed based on International Classification of Diseases 9/10 codes in majority of the included studies. PPI use was not associated with the dementia risk, with a pooled relative risk (RR) of 1.05 (95% confidence interval [CI]: 0.96-1.15), P = 0.31. Subgroup analysis based on study design (cohort: P = 0.14; case-control: P = 0.14), sex (RR 1.25 [95% CI: 0.97-1.60], P = 0.08), histamine 2 receptor antagonist blockers (P = 0.93), and Alzheimer's disease (RR 1.00 [95% CI: 0.91-1.09], P = 0.93) revealed no significant association between PPI use and dementia risk.
We found no significant association between PPI use and the risk of dementia or Alzheimer's disease.
越来越多的文献表明，痴呆风险与质子泵抑制剂（PPI）的使用之间存在关联。因此，我们旨在研究 PPI 使用与痴呆风险之间的关联。
我们在 PubMed、Embase 和 Cochrane 数据库中进行了广泛的文献检索，检索时间截至 2019 年 3 月 31 日。所有评估 PPI 使用与痴呆风险之间关联的研究（队列研究和病例对照研究）均符合纳入标准。根据标题和摘要筛选文章，提取数据，并使用 Newcastle-Ottawa 量表评估偏倚风险。主要结局是 PPI 使用组与非 PPI 使用组相比痴呆的发生风险。次要结局包括基于亚组的痴呆风险。使用 Review Manager 软件进行统计分析。
共纳入 12 项研究（8 项队列研究和 4 项病例对照研究）。大多数研究质量较高。大多数纳入的研究基于国际疾病分类第 9 或 10 版（ICD-9/10）诊断痴呆。PPI 使用与痴呆风险无关，合并相对风险（RR）为 1.05（95%置信区间 [CI]：0.96-1.15），P = 0.31。基于研究设计（队列研究：P = 0.14；病例对照研究：P = 0.14）、性别（RR 1.25 [95% CI：0.97-1.60]，P = 0.08）、组胺 2 受体拮抗剂阻滞剂（P = 0.93）和阿尔茨海默病（RR 1.00 [95% CI：0.91-1.09]，P = 0.93）的亚组分析未发现 PPI 使用与痴呆风险之间存在显著关联。
我们未发现 PPI 使用与痴呆或阿尔茨海默病风险之间存在显著关联。
