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A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study.

Jo Y, Park E, Ahn SB, Jo YK, Son B, Kim SH, Park YS, Kim HJ - Gut Liver (2015)

Bottom Line: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H(+)-K(+)-ATPase in proton pumps.According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD.Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H(+)-ATPase in osteoclasts.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Proton pump inhibitors (PPIs) act by irreversibly binding to the H(+)-K(+)-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H(+)-ATPase in osteoclasts.

Methods: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H(+)-K(+)-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period.

Results: Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD.

Conclusions: In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H(+)-ATPase in osteoclasts.

No MeSH data available.


Related in: MedlinePlus

Study diagram.BMD, bone mineral densitometry.
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f1-gnl-09-607: Study diagram.BMD, bone mineral densitometry.

Mentions: Sixty-five patients were selected initially, and 26 of them were excluded by incongruity or personal refusal. The remaining 39 patients were randomly divided into two groups (PPI, n=20; revaprazan, n=19). Then, the PPI or revaprazan was randomly assigned to each group for 8 weeks. During the experiment, five patients from each group were excluded due to loss to follow-up or discontinued intervention. After medication, two patients from the PPI group and one patient from the revaprazan group were excluded due to osteoporosis (BMD ≤-2.5). In the end, 26 patients (PPI, n=13; revaprazan, n=13) finished undergoing the intention-to-treat analysis (Fig. 1).


A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study.

Jo Y, Park E, Ahn SB, Jo YK, Son B, Kim SH, Park YS, Kim HJ - Gut Liver (2015)

Study diagram.BMD, bone mineral densitometry.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562777&req=5

f1-gnl-09-607: Study diagram.BMD, bone mineral densitometry.
Mentions: Sixty-five patients were selected initially, and 26 of them were excluded by incongruity or personal refusal. The remaining 39 patients were randomly divided into two groups (PPI, n=20; revaprazan, n=19). Then, the PPI or revaprazan was randomly assigned to each group for 8 weeks. During the experiment, five patients from each group were excluded due to loss to follow-up or discontinued intervention. After medication, two patients from the PPI group and one patient from the revaprazan group were excluded due to osteoporosis (BMD ≤-2.5). In the end, 26 patients (PPI, n=13; revaprazan, n=13) finished undergoing the intention-to-treat analysis (Fig. 1).

Bottom Line: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H(+)-K(+)-ATPase in proton pumps.According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD.Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H(+)-ATPase in osteoclasts.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Proton pump inhibitors (PPIs) act by irreversibly binding to the H(+)-K(+)-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H(+)-ATPase in osteoclasts.

Methods: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H(+)-K(+)-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period.

Results: Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD.

Conclusions: In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H(+)-ATPase in osteoclasts.

No MeSH data available.


Related in: MedlinePlus