科研之友
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摘要
Background: Acid-suppressive medications are widely used for the management of acid-related disorders. It has been reported that acid-suppressive medication users were at increased risk of fracture, but such an association was inconsistent among observational studies. The purpose of our analysis was to assess the relationship between use of antacid drugs and fracture risk. Methods: We systematically searched electronic database and manually examined the reference lists of previous reviews for potentially eligible studies. Given the heterogeneity across studies, random effects models were used to calculate summary estimates. Subgroup analysis and sensitivity analysis were conducted to explore the potential heterogeneity. Results: 18 studies met our inclusion criteria. PPI and H(2)RA were associated with increased risk of hip fracture, with substantial heterogeneity (PPI: 1.216, 1.134-1.304, I-2= 71.3%; H(2)RA: 1.128, 1.022-1.245, I-2= 72.1%). High risk of spine fracture was observed in PPI users (1.216, 95% CI: 1.134-1.304) but not H(2)RA users. When considering 5 studies conducted among postmenopausal women, the RR was 1.376, (95% CI: 1.043-1.816) with modest heterogeneity (I-2= 57.7%). Subgroup analysis and sensitivity analysis found consistent association between hip fracture risk and PPI use but not H(2)RA use. Positive association for H(2)RA use lost its significance when considering case-control studies and European studies. Conclusion: Results of this updated meta-analysis provided evidence to support that acid-suppressive medications were associated with increased risk of fracture, especially hip fracture.
- 出版日期2015
- 单位南京大学
