ArticleThe Journal of clinical endocrinology and metabolism2025
Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Co-administration of calcium carbonate or sodium bicarbonate prevents esomeprazole-induced osteoporosis.Scientific reports · 2026Article
- Bone microarchitectural degradation in hypertensive patients: a population-based study.Archives of osteoporosis · 2026Article
- Impact of Proton Pump Inhibitor Therapy on Bone Mineral Density: An Updated Systematic Review.Cureus · 2026Review
- Linking the relationship between drug-induced osteoporosis and the gut microbiota.Frontiers in endocrinology · 2026Review
- FAERS-based pharmacovigilance and network toxicology analysis of esomeprazole-associated osteoporosis.PloS one · 2026Article
- Medication-Related Impacts on Pediatric Bone Health.Journal of the Pediatric Orthopaedic Society of North America · 2025Review
- Proton pump inhibitor exposure, trabecular bone score, and BMD: a registry-based cohort study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Sex-specific Association of Chronic Proton Pump Inhibitor Use With Reduced Bone Density and Quality.The Journal of clinical endocrinology and metabolism · 2025Article
- Exploring the mechanisms and targets of proton pump inhibitors-induced osteoporosis through network toxicology, molecular docking, and molecular dynamics simulations.Frontiers in pharmacology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextChronic use of proton pump inhibitors (PPIs) has been associated with an increase in bone fragility. However, evidence on the effect of chronic PPI use on bone density is conflicting, and data on bone microarchitectural quality are scarce.
objectiveThe primary aim of this study was to evaluate whether trabecular bone microarchitecture, assessed by trabecular bone score (TBS), is altered in chronic PPI users. The association between PPI use and bone density was also evaluated as a secondary endpoint.
methodsWe extracted individual patient data from the 2005 to 2008 cycles of the population-based National Health and Nutrition Examination Survey (NHANES), in which lumbar spine dual-energy X-ray absorptiometry scans were acquired. TBS values were calculated from dual-energy X-ray absorptiometry images using a dedicated software. Multivariable linear regression analyses stratified by sex were performed to evaluate the association of chronic PPI use with TBS and bone mineral density (BMD), adjusting for relevant confounders.
resultsA total of 7478 subjects were included (3961 men, 3517 women). After adjustment for relevant confounders, chronic PPI use was associated with a worse bone health profile in men, with lower TBS (-0.039; 95% CI, -0.058 to -0.020; P < .001), lumbar spine T-score (-0.27; 95% CI, -0.51 to -0.04; P = .023), total hip T-score (-0.21; 95% CI, -0.41 to -0.01; P = .041), and femoral neck T-score (-0.22; 95% CI, -0.44 to -0.00; P = .047). Notably, the association between chronic PPI use and degraded TBS remained statistically significant even after further adjustment for BMD at lumbar spine and femoral neck (-0.026; 95% CI, -0.039 to -0.012; P = .001). In contrast, no significant association was observed between chronic PPI use and either TBS or BMD in women.
conclusionChronic PPI use is associated with degraded trabecular bone quality in men, even after adjustment for BMD. No association was observed in women.
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