Increased Risk of Fractures and Use of Proton Pump Inhibitors in Menopausal Women: A Systematic Review and Meta-Analysis

Int J Environ Res Public Health. 2022 Oct 19;19(20):13501. doi: 10.3390/ijerph192013501.

Abstract

Proton pump inhibitors (PPIs) can directly interfere with osteoclastic function, induce hypergastrinemia, and inhibit calcium absorption, leading to reduced bone mineral density (BMD), a measure of bone metabolism that may be associated with the risk of fractures. The current study involves a systematic review and meta-analysis aimed at assessing the relationship between prolonged use of PPI drugs and fractures in menopausal women. A systematic search and meta-analysis were performed on PubMed, Scopus, and Science Direct databases according to PRISMA guidelines. Two independent reviewers analyzed the articles. The five articles found in the databases, which met the eligibility criteria, covered participants who were menopausal women aged between 56 and 78.5 years, using or not using a PPI for a minimum of 12 months. All studies showed an increase in the rate of fractures related to using PPIs, as an outcome. Prolonged use of PPIs in menopausal women can affect bone metabolism and cause fractures. However, other factors, such as the use of other classes of drugs, obesity, low weight, poor diet, replacement hormones, and comorbidities, should also be considered for assessing the risk of fractures.

Keywords: fracture risk; menopause; proton pump inhibitors; woman.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Density
  • Calcium
  • Child
  • Child, Preschool
  • Female
  • Fractures, Bone* / epidemiology
  • Hormones
  • Humans
  • Menopause
  • Proton Pump Inhibitors* / adverse effects

Substances

  • Proton Pump Inhibitors
  • Calcium
  • Hormones

Grants and funding

The authors would like to thank the National Council for the Improvement of Higher Education (CAPES-PROSUP) for granting a scholarship to Thuila Ferreira da Maia and Fundação Araucária (FA-CAPES) for granting the scholarship to Bruna Gafo de Camargo.