A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study.
- Author:
Yunju JO
1
;
Eunkyoung PARK
;
Sang Bong AHN
;
Young Kwan JO
;
Byungkwan SON
;
Seong Hwan KIM
;
Young Sook PARK
;
Hyo Jeong KIM
Author Information
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords: Bone metabolism; Hydrogen potassium ATPase; Osteoclasts; Osteoporosis; Proton pump inhibitors
- MeSH: Aged; Amino Acids/drug effects/urine; Bone Remodeling/*drug effects; Bone and Bones/*metabolism; Calcium/blood; Female; Humans; Intention to Treat Analysis; Linear Models; Male; Middle Aged; Multivariate Analysis; Osteoclasts/*metabolism; Prospective Studies; Proton Pump Inhibitors/*pharmacology; Pyrimidinones/*pharmacology; Tetrahydroisoquinolines/*pharmacology
- From:Gut and Liver 2015;9(5):607-614
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Proton pump inhibitors (PPIs) act by irreversibly binding to the H+-K+-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H+-ATPase in osteoclasts. METHODS: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H+-K+-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period. RESULTS: Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age > or =60 years was an independent predictor for the changes in serum calcium and urine DPD. CONCLUSIONS: In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H+-ATPase in osteoclasts.
