Pancreatic Function in Chronic Proton Pump Inhibitor Use: Findings from a Cross-Sectional Study

Proton pump inhibitors (PPIs) are widely used for acid-related disorders. Recent evidence suggests potential associations between long-term PPI use and pancreatic dysfunction, though findings remain inconsistent. This study aimed to evaluate pancreatic function in patients on long-term PPI therapy.

A cross-sectional study was conducted in a tertiary care hospital from March 2023 to June 2024. Ninety-seven adults aged 18-65 years who were using PPIs (≥three doses/week for ≥eight weeks) were recruited from outpatient services. Patients with diabetes or those on medications affecting glucose metabolism were excluded. Blood samples were analyzed for C-peptide, amylase, glycated hemoglobin (HbA1c) and random blood sugar (RBS). C-peptide levels were categorized as normal (≤4.20 ng/mL) or abnormal (>4.20 ng/mL). Other biochemical parameters were also similarly classified using standard laboratory cut-offs. Prevalence of dysfunction was expressed as percentages. Associations between C-peptide levels and age, sex, amylase, HbA1c, RBS, PPI type and duration were assessed using odds ratios and Chi-square/Fisher's exact tests.

Participants had a mean age of 51.2 years and 62.9% of them were females. The most common PPI was pantoprazole (76.3%). Abnormal C-peptide levels were observed in 10.3% of participants. Raised HbA1c levels were noted in 48.5% of subjects. There were no significant associations with pancreatic function and age, sex, type and duration of PPI treatment.

No definitive association between chronic PPI usage and pancreatic dysfunction could be established. A possible association may be suspected due to the high prevalence of raised HbA1c levels in long-term PPI users. Further studies are required to elaborate on these findings.