质子抑制剂暴露,骨评分和骨矿物质密度:基于注册表的队列研究
Fatima Zarzour1, John T Schousboe2,3, Neil Binkley4
1University of Manitoba, Canada.
概括
质子抑制剂的使用与腹部肥胖有关,而不是骨密度下降. 对腹部测量进行调整,消除了质子抑制剂与较低的骨分数或密度之间的明显关联.
科学领域:
- 骨代谢和药理学的骨代谢和药理学
- 肥胖和代谢健康问题
背景情况:
- 质子抑制剂 (PPI) 经常被处方,可能与骨健康状况下降有关.
- 之前的研究表明,PPI对骨矿物质密度 (BMD) 和脊椎骨分数 (TBS) 的影响不一致.
- 与胃食道疾病和PPI使用相关的腹部肥胖可能会混PPI与骨健康关系.
研究的目的:
- 调查PPI使用与TBS和BMD之间的关联.
- 为了确定腹部肥胖,以形腹部直径 (SAD) 测量,是否会混PPI-骨健康关系.
主要方法:
- 一项涉及60,930人 (18.6%的PPI使用者) 的大型队列研究通过药物持续率评估了PPI暴露.
- 使用DXA测量了椎骨分数 (TBS) 和骨矿物密度 (BMD),并将SAD作为腹部肥胖的衡量标准.
- 后勤回归模型被用于分析SAD和其他共变量调整之前和之后的关联.
主要成果:
- 最小调整的模型显示,与较低的TBS和BMD相关的PPI使用增加.
- 与非使用者相比,PPI使用者有更大的腹直径 (SAD).
- 在对SAD进行调整后,PPI使用与较低的TBS或BMD之间的关联不再显著.
- 纵向分析显示,在PPI使用者中,骨损失没有增加.
结论:
- 使用PPI与增加腹部肥胖 (SAD) 有关.
- 腹部肥胖症混了PPI使用和TBS/BMD之间的关系.
- 当调整为腹部肥胖等混因素时,PPI暴露不会显著减少TBS或BMD.
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