Proton-pump inhibitor use and hip fractures in men: a population-based case-control study

作者：Adams Annette L^*; Black Mary Helen; Zhang Jian L; Shi Jiaxiao M; Jacobsen Steven J

来源：Annals of Epidemiology, 2014, 24(4): 286-290.

DOI：10.1016/j.annepidem.2014.01.004

• Epidemiology
• Pharmacoepidemiology
• Proton pump inhibitor
• PPI
• Hip fractures

Purpose: To estimate the association between proton-pump inhibitor (PPI) use and hip fracture.
Methods: We conducted a case-control study of 6774 pairs of men aged 45 years or older, matched on age, race, and medical center. Cases sustained incident hip fractures in 1997-2006. Fracture date was index date for each case-control pair. PPI exposure was identified from electronic pharmacy records, 1991-2006. PPI use was measured as (1) ever versus never; (2) adherence; (3) duration; and (4) recentness. Omeprazole and pantoprazole were analyzed separately using conditional logistic regression, adjusted for comorbidities. Nonusers were the referent group.
Results: Eight hundred ninety-six (13.2%) cases and 713 (10.5%) controls used omeprazole before index date (matched odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27). Greatest adherence (medication possession ratio > 80%) (OR, 1.33; 95% CI, 1.09-1.62), highest tertile of duration (OR, 1.23; 95% CI, 1.02-1.48), and recent use (OR, 1.22; 95% CI, 1.02-1.47) were associated with hip fracture. Six hundred ninety-four (10.2%) cases and 576 (8.5%) controls had used pantoprazole (OR, 1.10; 95% CI, 0.97-1.24). Longest duration (OR, 1.25; 95% CI, 1.02-1.53) and most recent use (OR, 1.38; 95% CI, 1.12-1.71) were associated with hip fracture. Our study suggests that PPI use and hip fractures are associated, with risk increasing with longer duration and more recent use.

• 出版日期2014-4