Study Links Medication to Osteoporosis Risk in Women

by | Feb 23, 2017 | 2016, Bone Health, Women's Health - Bone Health

Written by Greg Arnold, DC, CSCS. Researchers, when analyzing data from a German patient database, found that 3,092 osteoporotic women who took proton pump inhibitors, had a significantly higher risk of developing ulcers and gastritis than their matched 3,092 healthy controls.

women's health osteoporosisAccording to the National Osteoporosis Foundation, 54 million Americans have osteoporosis, and 50% of women and 25% of men will suffer a broken bone due to this condition. These broken bones add an annual cost of $19 billion to the U.S. healthcare system and this is expected increase to $25.3 billion by 2025 1. When looking at worldwide statistics, osteoporosis is estimated to affect over 200 million people 2. 

The most common risk factor for osteoporosis is a lack of physical activity 3. Gastrointestinal disorders such as Celiac disease, Crohn’s disease, and ulcerative colitis that are often a source of chronic inflammation are also risk factors for osteoporosis. Research has validated their potential to alter bone remodeling 4. For these digestive conditions, doctors aim to limit stomach acid production and prescribe a medication called a proton pump inhibitor 5.

Studies in 2006 6, 2008 7, and early in 2016 5 suggest that proton pump inhibitors are risk factors for osteoporosis, although a 2010 study did not find an increased risk 8. In a 2016 study 9, researchers, using data from a German patient database, analyzed data on 3,092 osteoporotic women aged 67 to 77 and 3,092 age-matched women without osteoporosis 10.

The researchers found a significantly higher proportion of women with osteoporosis suffered from digestive problems compared to the control group:

Control GroupOsteoporosis Group
p-value
Disorders of the esophagus21.40%31.7%
(73.3% higher than control group)
< 0.001
Ulcers4.40%7.1%
(61.3% higher than control group)
< 0.001
Gastritis29.10%39.3%
(35% higher than control group)
< 0.001

Researchers identified a 62% increased risk of osteoporosis in women taking PPIs compared to women not taking proton pump inhibitors (p < 0.001). This increased risk was proportional to the duration of proton pump inhibitor use. There was a 58% increased risk after 1 year of proton pump inhibitor use to a 72% increased risk after 5 years of use (p < 0.001).

For the researchers, “The use of proton pump inhibitor drugs was a risk factor for osteoporosis and this risk increased with therapy duration in postmenopausal women in Germany”. They added that “disorders of the esophagus and gastritis/duodenitis also increased the risk of developing this chronic condition.” The researchers concluded by recommending that “Further studies are required to gain a better understanding of such associations.”

Source: L. Jacob, P. Hadji & K. Kostev (2016) The use of proton pump inhibitors is positively associated with osteoporosis in postmenopausal women in Germany, Climacteric, 19:5, 478-481, DOI: 10.1080/13697137.2016.1200549

© 2016 International Menopause Society

Posted February 23, 2017.  

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. Foundation NO. What is Osteoporosis and What Causes It? 2017; Overview of Osteoporosis and Its Causes. Available at: https://www.nof.org/patients/what-is-osteoporosis/. Accessed February 19, 2017, 2917.
  2. Foundation IO. Facts and Statistics. 2015; Facts and statistics about osteoporosis. Available at: https://www.iofbonehealth.org/facts-statistics. Accessed February 20, 2017, 2017.
  3. Foundation NO. Are You at Risk? 2017; Risk factors for osteoporosis. Available at: https://www.nof.org/preventing-fractures/general-facts/bone-basics/are-you-at-risk/. Accessed February 20, 2017, 2017.
  4. Katz S, Weinerman S. Osteoporosis and gastrointestinal disease. Gastroenterol Hepatol (NY). 2010;6(8):506-517.
  5. Chen C-H, Lin C-L, Kao C-H. Gastroesophageal reflux disease with proton pump inhibitor use is associated with an increased risk of osteoporosis: a nationwide population-based analysis. Osteoporosis International. 2016;27(6):2117-2126.
  6. Vestergaard P, Rejnmark L, Mosekilde L. Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture. Calcified tissue international. 2006;79(2):76-83.
  7. Targownik LE, Lix LM, Metge CJ, Prior HJ, Leung S, Leslie WD. Use of proton pump inhibitors and risk of osteoporosis-related fractures. Canadian Medical Association Journal. 2008;179(4):319-326.
  8. Targownik LE, Lix LM, Leung S, Leslie WD. Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology. 2010;138(3):896-904.
  9. Jacob L, Hadji P, Kostev K. The use of proton pump inhibitors is positively associated with osteoporosis in postmenopausal women in Germany. Climacteric. 2016;19(5):478-481.
  10. Becher H, Kostev K. pharmacology and therape. International journal of clinical pharmacology and therapeutics. 2009;47(10):617-626.